Organization Name: | WOODRIDGE PSYCHOLOGICAL ASSOC PA |
NPI Number: | 1013951268 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TERRY LEE LEDFORD (PRESIDENT) |
Mailing Address: | 182 W Court St Rutherfordton |
State: | NC US |
Postal Code: | 28139 |
Phone Number: | 8282877806 |
Fax Number: | 8282870004 |
NPI Enumeration Date: | 06/16/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |