Individual
MRS. ELISHA ANN WOODYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC III
Contact information
Practice address
452 W MARKET ST, XENIA, OH 45385-2815
(937) 376-8700
(937) 376-8725
Mailing address
452 W MARKET ST, XENIA, OH 45385-2815
(937) 376-8700
(937) 376-8725
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDCIII.161361
OH
101YM0800X
Mental Health Counselor
Primary
C2103747
OH
390200000X
Student in an Organized Health Care Education/Training Program
C2002217-TRNE
OH
Other
Enumeration date
04/27/2018
Last updated
10/22/2021
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