Individual
JESSICA WOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A, L.P.C.
Contact information
Practice address
3011KETTERING BLVD, SUITE 311, MORAINE, OH 45439
(937) 424-0210
Mailing address
569 VISTA AVE, VANDALIA, OH 45377-1845
(937) 681-9164
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C 1300245
OH
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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