Provider Demographics
NPI:1649771437
Name:WOODIN, GWEN E (MA)
Entity Type:Individual
Prefix:
First Name:GWEN
Middle Name:E
Last Name:WOODIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 PAGE HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16340-7113
Mailing Address - Country:US
Mailing Address - Phone:814-730-4593
Mailing Address - Fax:
Practice Address - Street 1:815 GRANDVIEW RD
Practice Address - Street 2:
Practice Address - City:OIL CITY
Practice Address - State:PA
Practice Address - Zip Code:16301-2077
Practice Address - Country:US
Practice Address - Phone:814-676-5614
Practice Address - Fax:814-677-5760
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health