Provider Demographics
NPI:1285816348
Name:WOODARD, ADRIENNE (SPP)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:WOODARD
Suffix:
Gender:F
Credentials:SPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 NEWPORT RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19804-3425
Mailing Address - Country:US
Mailing Address - Phone:302-449-3602
Mailing Address - Fax:
Practice Address - Street 1:1417 NEWPORT RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19804-3425
Practice Address - Country:US
Practice Address - Phone:302-449-3602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEO1-0000252235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist