Provider Demographics
NPI:1144382300
Name:YOUNG- WOODS, CRESSINDA (DPT)
Entity Type:Individual
Prefix:
First Name:CRESSINDA
Middle Name:
Last Name:YOUNG- WOODS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CRESSINDA
Other - Middle Name:
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:2400 WISTERIA DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2689
Mailing Address - Country:US
Mailing Address - Phone:770-982-0102
Mailing Address - Fax:770-982-0130
Practice Address - Street 1:2400 WISTERIA DR
Practice Address - Street 2:SUITE A
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2689
Practice Address - Country:US
Practice Address - Phone:770-982-0102
Practice Address - Fax:770-982-0130
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008227225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist