Provider Demographics
NPI:1417248980
Name:WOODS, KATHY L (PLPC)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:L
Last Name:WOODS
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 N WATERFORD DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-2522
Mailing Address - Country:US
Mailing Address - Phone:314-496-1861
Mailing Address - Fax:
Practice Address - Street 1:2620 N WATERFORD DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-2522
Practice Address - Country:US
Practice Address - Phone:314-496-1861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010007559101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional