Provider Demographics
NPI:1508393752
Name:WOODRUFF, LINDSEY JEANNE (MS)
Entity type:Individual
Prefix:MISS
First Name:LINDSEY
Middle Name:JEANNE
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 E ESTATES BLVD APT N
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-5672
Mailing Address - Country:US
Mailing Address - Phone:304-616-2691
Mailing Address - Fax:
Practice Address - Street 1:421 BARONY ST STE 3
Practice Address - Street 2:
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461-3145
Practice Address - Country:US
Practice Address - Phone:843-790-4093
Practice Address - Fax:843-501-2297
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6491235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist