Individual
ALLEN GERALD WOODHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RADT1
Contact information
Practice address
991 POSTAL WAY APT 4, VISTA, CA 92083-6932
(760) 525-2656
Mailing address
993 POSTAL WAY, VISTA, CA 92083-6945
(760) 525-2656
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/06/2018
Last updated
07/06/2018
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