Individual
JERRY WOODLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
702 BROADWAY BLVD SE, ALBUQUERQUE, NM 87102-4285
(505) 394-8412
Mailing address
819 FORRESTER NE, APT B, ALBUQUERQUE, NM 87102
(505) 394-8412
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/17/2020
Last updated
11/17/2025
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