Provider Demographics
NPI:1376504001
Name:WOODIS, LINDSAY (OT)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:WOODIS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:WOODIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3004 W FAIDLEY AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-4109
Mailing Address - Country:US
Mailing Address - Phone:308-382-0344
Mailing Address - Fax:
Practice Address - Street 1:3004 W FAIDLEY AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4109
Practice Address - Country:US
Practice Address - Phone:308-382-0344
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1029225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist