Provider Demographics
NPI:1689701849
Name:WODZINSKI, SYLVIE MARIA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SYLVIE
Middle Name:MARIA
Last Name:WODZINSKI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 1ST ST
Mailing Address - Street 2:UNIT A
Mailing Address - City:INDIAN ROCKS BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33785-2945
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1809 1ST ST
Practice Address - Street 2:UNIT A
Practice Address - City:INDIAN ROCKS BEACH
Practice Address - State:FL
Practice Address - Zip Code:33785-2945
Practice Address - Country:US
Practice Address - Phone:847-567-1636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA14741235Z00000X
IL146.010096235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59143OtherBLUE CROSS BLUE SHIELD
FL019151000Medicaid
FL019151000Medicaid