Provider Demographics
NPI:1336222637
Name:WOODY, AMY ELIZABETH (EDS CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:AMY
Middle Name:ELIZABETH
Last Name:WOODY
Suffix:
Gender:F
Credentials:EDS CCC-SLP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:520 COOK ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:MADISONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37354-1508
Mailing Address - Country:US
Mailing Address - Phone:423-442-1440
Mailing Address - Fax:423-442-1441
Practice Address - Street 1:520 COOK ST
Practice Address - Street 2:SUITE D
Practice Address - City:MADISONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37354-1508
Practice Address - Country:US
Practice Address - Phone:423-442-1440
Practice Address - Fax:423-442-1441
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNSP 0000003108235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist