Individual
KIMBERLY WOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2103 E WASHINGTON ST STE 4B, BLOOMINGTON, IL 61701-4362
(309) 304-3047
Mailing address
2103 E WASHINGTON ST STE 4B, BLOOMINGTON, IL 61701-4362
(309) 706-1028
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.007507
IL
Other
Enumeration date
12/29/2022
Last updated
02/09/2023
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