Provider Demographics
NPI:1477607430
Name:WOODSMALL, CRAIG MORGAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:MORGAN
Last Name:WOODSMALL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 BROOKINGS DR
Mailing Address - Street 2:WASHINGTON UNIVERSITY, CAMPUS BOX 1201
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-4862
Mailing Address - Country:US
Mailing Address - Phone:314-935-5988
Mailing Address - Fax:314-935-8515
Practice Address - Street 1:1 BROOKINGS DR
Practice Address - Street 2:WASHINGTON UNIVERSITY, CAMPUS BOX 1201
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63130-4862
Practice Address - Country:US
Practice Address - Phone:314-935-5988
Practice Address - Fax:314-935-8515
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005028855103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical