Provider Demographics
NPI:1447013958
Name:WOODSON, ARRA (LSW)
Entity type:Individual
Prefix:
First Name:ARRA
Middle Name:
Last Name:WOODSON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 325
Mailing Address - Street 2:
Mailing Address - City:WATERFORD WORKS
Mailing Address - State:NJ
Mailing Address - Zip Code:08089-0325
Mailing Address - Country:US
Mailing Address - Phone:609-513-7635
Mailing Address - Fax:609-878-3190
Practice Address - Street 1:57 WATERFORD RD
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-2328
Practice Address - Country:US
Practice Address - Phone:609-513-7635
Practice Address - Fax:609-878-3190
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07077800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker