Provider Demographics
NPI:1366851735
Name:WOODS, AILENE MARIE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:AILENE
Middle Name:MARIE
Last Name:WOODS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14235 W PORT ROYALE LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-8749
Mailing Address - Country:US
Mailing Address - Phone:601-325-6915
Mailing Address - Fax:
Practice Address - Street 1:14235 W PORT ROYALE LN
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-8749
Practice Address - Country:US
Practice Address - Phone:601-325-6915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-10
Last Update Date:2014-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST0461106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist