Provider Demographics
NPI:1558788406
Name:WOODS-PETITTI, MARIE (OTR)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:
Last Name:WOODS-PETITTI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 FAIRWATER PARK DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6655
Mailing Address - Country:US
Mailing Address - Phone:281-334-4421
Mailing Address - Fax:
Practice Address - Street 1:17045 EL CAMINO REAL STE 106
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2623
Practice Address - Country:US
Practice Address - Phone:281-480-5648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109648225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist