Provider Demographics
NPI:1639627458
Name:WOODS, TAWANNA (MS MFT)
Entity Type:Individual
Prefix:MISS
First Name:TAWANNA
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:MS MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4093 SILVER GLN
Mailing Address - Street 2:
Mailing Address - City:HAHIRA
Mailing Address - State:GA
Mailing Address - Zip Code:31632-3256
Mailing Address - Country:US
Mailing Address - Phone:229-507-6760
Mailing Address - Fax:
Practice Address - Street 1:4093 SILVER GLN
Practice Address - Street 2:
Practice Address - City:HAHIRA
Practice Address - State:GA
Practice Address - Zip Code:31632-3256
Practice Address - Country:US
Practice Address - Phone:229-507-6760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor