Provider Demographics
NPI:1447562871
Name:WOODSON, DANIELLE CHRISTINE (OT)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:CHRISTINE
Last Name:WOODSON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MISS
Other - First Name:DANIELLE
Other - Middle Name:CHRISTINE
Other - Last Name:COPELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17651 B HWY
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65233-2839
Mailing Address - Country:US
Mailing Address - Phone:660-882-4126
Mailing Address - Fax:
Practice Address - Street 1:17651 B HWY
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:MO
Practice Address - Zip Code:65233-2839
Practice Address - Country:US
Practice Address - Phone:660-882-4126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010022868225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist