Provider Demographics
NPI:1336190479
Name:WOODS, CHRISTINA
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:WOODS
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 1:713 WESTWOOD OFFICE PARK
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-5115
Mailing Address - Country:US
Mailing Address - Phone:540-361-1844
Mailing Address - Fax:540-361-1874
Practice Address - Street 1:713 WESTWOOD OFFICE PARK
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5115
Practice Address - Country:US
Practice Address - Phone:540-361-1844
Practice Address - Fax:540-361-1874
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040047091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA267478OtherBC/BS OF VA
VA267478OtherBC/BS OF VA
VA00X374C01Medicare PIN