Provider Demographics
NPI:1255782009
Name:WOODS, SPENCER ARLEIGH
Entity type:Individual
Prefix:MRS
First Name:SPENCER
Middle Name:ARLEIGH
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10259 HIGHWAY 63 N
Mailing Address - Street 2:APT 12
Mailing Address - City:BONO
Mailing Address - State:AR
Mailing Address - Zip Code:72416-8677
Mailing Address - Country:US
Mailing Address - Phone:870-819-7833
Mailing Address - Fax:
Practice Address - Street 1:10259 HIGHWAY 63 N
Practice Address - Street 2:APT 12
Practice Address - City:BONO
Practice Address - State:AR
Practice Address - Zip Code:72416-8677
Practice Address - Country:US
Practice Address - Phone:870-819-7833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR#15-0282355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant