Individual
ROSHUNDA CHRISTINE WOODEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4601 CATAMARAN DR APT 921, FORT WORTH, TX 76135-2583
(817) 965-9090
Mailing address
3154 OLD HICKORY TRL, FOREST HILL, TX 76140-1872
(817) 965-9090
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
TX
376K00000X
Nurse's Aide
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12038415
DRIVER LICENSE
TX
Enumeration date
05/11/2022
Last updated
10/13/2023
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