Provider Demographics
NPI:1184794570
Name:WOODARD, LYNLEE WINIFRED (BSC, MPSYCH, PHD)
Entity type:Individual
Prefix:DR
First Name:LYNLEE
Middle Name:WINIFRED
Last Name:WOODARD
Suffix:
Gender:F
Credentials:BSC, MPSYCH, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-3202
Mailing Address - Country:US
Mailing Address - Phone:702-682-3961
Mailing Address - Fax:
Practice Address - Street 1:3075 E FLAMINGO RD
Practice Address - Street 2:#108
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-7483
Practice Address - Country:US
Practice Address - Phone:702-486-7593
Practice Address - Fax:702-486-7522
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health