Jerry Woodle
Social Worker, Clinical in Albuquerque, NM. Individual provider (NPI-1).
NPI number1962018697
StatusActive
Last updated in NPPESNov 17, 2025
Details
- NPI
- 1962018697
- Entity type
- Individual (NPI-1)
- Name
- Jerry Woodle
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 17, 2020
- Certification date
- Nov 17, 2025
- Last updated
- Nov 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
Practice location
702 Broadway Blvd SeAlbuquerque, NM 87102-4285
Phone 505-394-8412
Mailing address
819 Forrester NeApt B
Albuquerque, NM 87102
Phone 505-394-8412
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