Provider Demographics
NPI:1740037886
Name:WOOLDRIDGE, KATHERINE GRACE (BA)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:GRACE
Last Name:WOOLDRIDGE
Suffix:
Gender:X
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129 NW 30TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-7901
Mailing Address - Country:US
Mailing Address - Phone:405-459-0009
Mailing Address - Fax:
Practice Address - Street 1:2129 NW 30TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7901
Practice Address - Country:US
Practice Address - Phone:405-459-0009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist