Provider Demographics
NPI:1134992761
Name:WOODCOCK, ASHLEY LAUREN (RDN)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:LAUREN
Last Name:WOODCOCK
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5904 FOREST RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-7824
Mailing Address - Country:US
Mailing Address - Phone:850-637-3155
Mailing Address - Fax:
Practice Address - Street 1:5904 FOREST RIDGE CIR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32526-7824
Practice Address - Country:US
Practice Address - Phone:850-637-3155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND5497133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered