Provider Demographics
NPI:1912280488
Name:WOODS, TAMI LEIGH (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TAMI
Middle Name:LEIGH
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 1:1327 E WASHINGTON AVE
Mailing Address - Street 2:PMB 143
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-5684
Mailing Address - Country:US
Mailing Address - Phone:956-428-5440
Mailing Address - Fax:956-428-3375
Practice Address - Street 1:595 W SESAME DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7962
Practice Address - Country:US
Practice Address - Phone:956-428-5440
Practice Address - Fax:956-428-3375
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106938235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1093891053Medicaid
TX456838Medicare Oscar/Certification