Provider Demographics
NPI:1760540504
Name:WOODS, DAVID RAYMOND (MS)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RAYMOND
Last Name:WOODS
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 N LA ARBOLETA ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-3439
Mailing Address - Country:US
Mailing Address - Phone:480-649-8196
Mailing Address - Fax:
Practice Address - Street 1:1141 N LA ARBOLETA ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-3439
Practice Address - Country:US
Practice Address - Phone:480-649-8196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP1345235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist