Provider Demographics
NPI:1538694781
Name:WOODRING, STEVEN LEE GRANT
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:LEE GRANT
Last Name:WOODRING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1771 AMBLER WAY
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89060-1581
Mailing Address - Country:US
Mailing Address - Phone:775-209-2324
Mailing Address - Fax:
Practice Address - Street 1:1731 S HIGHWAY 160
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-4711
Practice Address - Country:US
Practice Address - Phone:775-209-9213
Practice Address - Fax:775-419-6663
Is Sole Proprietor?:No
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor