Provider Demographics
NPI:1710671078
Name:WOOLSEY, JESSICA CATHERINE
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:CATHERINE
Last Name:WOOLSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 477 BOX 402
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96306-0005
Mailing Address - Country:US
Mailing Address - Phone:818-312-6867
Mailing Address - Fax:
Practice Address - Street 1:4315 50TH ST NW STE 100
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4369
Practice Address - Country:US
Practice Address - Phone:240-513-6108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator