Provider Demographics
NPI:1629896634
Name:WOODY, CYMPHANIE TAMARA
Entity type:Individual
Prefix:
First Name:CYMPHANIE
Middle Name:TAMARA
Last Name:WOODY
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 1:109 STONE RIDGE CMNS APT 110
Mailing Address - Street 2:
Mailing Address - City:SHIPPENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17257-8107
Mailing Address - Country:US
Mailing Address - Phone:484-797-6461
Mailing Address - Fax:
Practice Address - Street 1:77 N 3RD ST STE 201
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1835
Practice Address - Country:US
Practice Address - Phone:717-496-8127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health