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Individual
MS. PHYLLIS M WOODSON
Active
Individual
MS. PHYLLIS M WOODSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
R37612-2
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-033
TRICARE/CHAMPUS
VA
05
—
1790753382
—
VA
01
—
2116995
UHC/MAMSI
VA
01
—
PAR
VIRGINIA PREMIER HEALTH
VA
Enumeration date
03/09/2006
Last updated
08/05/2010
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