Provider Demographics
NPI:1356475602
Name:WOODS-SWEATLAND, MICHELLE LYNN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:WOODS-SWEATLAND
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WEST DR
Mailing Address - Street 2:
Mailing Address - City:GALES FERRY
Mailing Address - State:CT
Mailing Address - Zip Code:06335-1645
Mailing Address - Country:US
Mailing Address - Phone:860-884-8265
Mailing Address - Fax:860-464-7615
Practice Address - Street 1:3 WEST DR
Practice Address - Street 2:
Practice Address - City:GALES FERRY
Practice Address - State:CT
Practice Address - Zip Code:06335-1645
Practice Address - Country:US
Practice Address - Phone:860-884-8265
Practice Address - Fax:860-464-7615
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0002646235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist