Provider Demographics
NPI:1922490028
Name:WOODSON, NATALIA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:WOODSON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 HUNTERS VILLAGE RD UNIT 165
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3796
Mailing Address - Country:US
Mailing Address - Phone:407-668-0881
Mailing Address - Fax:
Practice Address - Street 1:19331 PADDOCK ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32833-5115
Practice Address - Country:US
Practice Address - Phone:407-668-0881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
FLSZ8497235Z00000X
FLSA17656235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist