Provider Demographics
NPI:1770785776
Name:WOODRING, JOELLEN KAE
Entity type:Individual
Prefix:MS
First Name:JOELLEN
Middle Name:KAE
Last Name:WOODRING
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 1:17577 WHITNEY RD
Mailing Address - Street 2:APT. 520
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-2457
Mailing Address - Country:US
Mailing Address - Phone:440-239-7702
Mailing Address - Fax:
Practice Address - Street 1:303 E BAGLEY RD
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:OH
Practice Address - Zip Code:44017-2040
Practice Address - Country:US
Practice Address - Phone:440-260-8372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0007797101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional