Provider Demographics
NPI:1376383901
Name:WOODS, ALLISON JAE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:JAE
Last Name:WOODS
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 1:6207 MAREN DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46224-3211
Mailing Address - Country:US
Mailing Address - Phone:513-288-3171
Mailing Address - Fax:
Practice Address - Street 1:5515 W 38TH ST STE 2300
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-2999
Practice Address - Country:US
Practice Address - Phone:317-880-0282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22005548A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist