Individual
STACEY CANDIDA WOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
3302 VILLA LN, DOUGLASVILLE, GA 30135
(678) 646-1468
Mailing address
3302 VILLA LN, DOUGLASVILLE, GA 30135-2832
(678) 646-1468
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0028905614
GA
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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