Provider Demographics
NPI:1336566835
Name:WOOLRIDGE, CARENDA
Entity Type:Individual
Prefix:
First Name:CARENDA
Middle Name:
Last Name:WOOLRIDGE
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 1:12816 BRANDON PL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-4456
Mailing Address - Country:US
Mailing Address - Phone:405-464-7957
Mailing Address - Fax:
Practice Address - Street 1:2601 NORTH WEST EXPRESSWAY
Practice Address - Street 2:SUITE 102E
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7272
Practice Address - Country:US
Practice Address - Phone:405-858-8656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-21
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health