Provider Demographics
NPI:1952982993
Name:WOOLEY, JANECE YVONNE
Entity Type:Individual
Prefix:
First Name:JANECE
Middle Name:YVONNE
Last Name:WOOLEY
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 1:7703 JASPER AVE APT 312
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-7784
Mailing Address - Country:US
Mailing Address - Phone:419-461-2266
Mailing Address - Fax:
Practice Address - Street 1:165 WELLS RD STE 203
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-3036
Practice Address - Country:US
Practice Address - Phone:419-461-2266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist