Individual
JESSE WILLARD WOODS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1410 N 31ST ST, PHILADELPHIA, PA 19121-3870
(215) 258-3481
Mailing address
1410 N 31ST ST, PHILADELPHIA, PA 19121-3870
(215) 258-3481
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
PA
172V00000X
Community Health Worker
—
—
174200000X
Meals Provider
—
—
344600000X
Taxi
—
—
347C00000X
Private Vehicle
Primary
—
—
347E00000X
Transportation Broker
—
—
372600000X
Adult Companion
—
—
Other
Enumeration date
04/20/2019
Last updated
04/03/2020
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