Provider Demographics
NPI:1235270521
Name:HOODWIN, MARCIA LYNN (MA CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:LYNN
Last Name:HOODWIN
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8236 SHADOW PINE WAY
Mailing Address - Street 2:ACCENTS AWAY
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-5618
Mailing Address - Country:US
Mailing Address - Phone:941-921-9533
Mailing Address - Fax:
Practice Address - Street 1:8236 SHADOW PINE WAY
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-5618
Practice Address - Country:US
Practice Address - Phone:941-921-9533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA3358235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL889796400Medicaid
FL52835OtherBCBS