Provider Demographics
NPI:1508393752
Name:WOODRUFF, LINDSEY JEANNE (MS)
Entity Type:Individual
Prefix:MISS
First Name:LINDSEY
Middle Name:JEANNE
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9325 BLUE HOUSE RD APT 12205
Mailing Address - Street 2:
Mailing Address - City:LADSON
Mailing Address - State:SC
Mailing Address - Zip Code:29456-4235
Mailing Address - Country:US
Mailing Address - Phone:304-616-2691
Mailing Address - Fax:
Practice Address - Street 1:777 STONY LANDING RD
Practice Address - Street 2:
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461-2949
Practice Address - Country:US
Practice Address - Phone:843-899-8870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2017-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC282021235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist