Provider Demographics
NPI:1013025725
Name:WOODS, SANDRA L (PT)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:L
Last Name:WOODS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:SANDRA
Other - Middle Name:L
Other - Last Name:CORDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:501 FAIRMOUNT AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5457
Mailing Address - Country:US
Mailing Address - Phone:410-927-8768
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:5500 KNOLL NORTH DR STE 150
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2476
Practice Address - Country:US
Practice Address - Phone:443-542-0062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
MD22120225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD01247075OtherAMERIGROUP
MD9570083OtherAETNA
MD841104OtherOPTUM
MD091189500Medicaid
MD1679630073OtherNPI FACILITY NUMBER
MDF7170016OtherCAREFIRST
MD212375OtherJHHC
MD283MS201OtherPTAN, MEDICARE