Individual
LARRY GEORGE WOOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD, HSPP
Contact information
Practice address
119 W MARKET ST, COLUMBIA CITY, IN 46725-2311
(260) 248-8176
(260) 248-2366
Mailing address
850 N HARRISON ST, ATTN: ANNE LAWSON, WARSAW, IN 46580-3163
(574) 267-7169
(574) 268-2377
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041608A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200307900A
—
IN
Enumeration date
11/21/2005
Last updated
04/20/2011
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