Provider Demographics
NPI:1871287177
Name:WOODS, LATASHIA
Entity type:Individual
Prefix:
First Name:LATASHIA
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 NORTH BRADDOCK AVENUE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-1261
Mailing Address - Country:US
Mailing Address - Phone:412-864-5004
Mailing Address - Fax:
Practice Address - Street 1:333 NORTH BRADDOCK AVENUE PITTSBURGH
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15208
Practice Address - Country:US
Practice Address - Phone:412-864-5004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA103TC1900X, 103TF0000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical