Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 007054 | NY |
NPI | 1992163521 |
---|---|
Provider Name | Dr. Alisa Genevieve Woods |
First Address | Potsdam, NY 13676-1816 |
Second Address | Potsdam, NY 13676-2173 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2016 |
Last Update Date | 10/02/2016 |