Healthcare Provider Details

I. General information

NPI: 1275787277
Provider Name (Legal Business Name): BRANDI WOODS SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2008
Last Update Date: 04/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12147 ROCK SWITCH ST
MILTON DE
19968-2677
US

IV. Provider business mailing address

12147 ROCK SWITCH ST
MILTON DE
19968-2677
US

V. Phone/Fax

Practice location:
  • Phone: 302-228-9888
  • Fax: 302-684-8931
Mailing address:
  • Phone: 302-228-9888
  • Fax: 302-684-8931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number01-0001028
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: