Provider Demographics
NPI:1780191163
Name:DR WOODS PSYCHOLOGY
Entity Type:Organization
Organization Name:DR WOODS PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:SAARI
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:321-704-4040
Mailing Address - Street 1:PO BOX 361212
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32936-1212
Mailing Address - Country:US
Mailing Address - Phone:321-209-3115
Mailing Address - Fax:
Practice Address - Street 1:1413 S PATRICK DR STE 1
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4344
Practice Address - Country:US
Practice Address - Phone:321-209-3115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-07
Last Update Date:2018-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9874251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health