Provider Demographics
NPI:1619304276
Name:WOODS, MARLYS (MT-BC)
Entity Type:Individual
Prefix:MISS
First Name:MARLYS
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13041 LORETTA DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-1819
Mailing Address - Country:US
Mailing Address - Phone:714-269-4178
Mailing Address - Fax:
Practice Address - Street 1:13041 LORETTA DR
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-1819
Practice Address - Country:US
Practice Address - Phone:714-269-4178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10644225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist