Provider Demographics
NPI:1568895258
Name:WOODS, CHRISTINE CARROLL (CHRISTINE WOODS)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:CARROLL
Last Name:WOODS
Suffix:
Gender:F
Credentials:CHRISTINE WOODS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 ELAINE RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-7626
Mailing Address - Country:US
Mailing Address - Phone:203-866-7998
Mailing Address - Fax:203-842-2213
Practice Address - Street 1:147 EAST AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5723
Practice Address - Country:US
Practice Address - Phone:203-866-7998
Practice Address - Fax:203-842-2213
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000207106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist