Provider Demographics
NPI:1164294922
Name:WOODS, TINA MARIE (SLP)
Entity Type:Individual
Prefix:MS
First Name:TINA MARIE
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 GLEN CARL RD
Mailing Address - Street 2:
Mailing Address - City:UPPER SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-1405
Mailing Address - Country:US
Mailing Address - Phone:845-825-1752
Mailing Address - Fax:
Practice Address - Street 1:26 GLEN CARL RD
Practice Address - Street 2:
Practice Address - City:UPPER SADDLE RIVER
Practice Address - State:NJ
Practice Address - Zip Code:07458-1405
Practice Address - Country:US
Practice Address - Phone:845-825-1752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018407235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist