Provider Demographics
NPI:1396406278
Name:WOODY, CHERYL DIANE (BS)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:DIANE
Last Name:WOODY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 SLAB CAMP RD
Mailing Address - Street 2:
Mailing Address - City:FRENCH CREEK
Mailing Address - State:WV
Mailing Address - Zip Code:26218-2153
Mailing Address - Country:US
Mailing Address - Phone:304-924-5319
Mailing Address - Fax:
Practice Address - Street 1:1029 OLD ELKINS ROAD
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201
Practice Address - Country:US
Practice Address - Phone:304-517-4562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist