Provider Demographics
NPI:1164892428
Name:WOODS, SHIRLEY (MSCCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 UTAH AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-1616
Mailing Address - Country:US
Mailing Address - Phone:202-363-1333
Mailing Address - Fax:
Practice Address - Street 1:5901 UTAH AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-1616
Practice Address - Country:US
Practice Address - Phone:202-363-1333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01833235Z00000X
DCSLP000519235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist