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Individual

JESSICA ERIN WALLACE WOODARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPCC, CEAP

Contact information

Practice address
4207 SAN ISIDRO ST NW, ALBUQUERQUE, NM 87107-2829
(505) 249-8174
(505) 792-0753
Mailing address
416 CAMINO DEL BOSQUE NW, ALBUQUERQUE, NM 87114-2302
(505) 249-8174
(505) 792-0753

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0158
NM

Other

Enumeration date
08/13/2006
Last updated
07/08/2007
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