Provider Demographics
NPI:1154771434
Name:WOOD, AUDREY (MS, SLP-CFY)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:MS, SLP-CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 SAINT CLAIR AVE SW
Mailing Address - Street 2:BUILDING 6
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5008
Mailing Address - Country:US
Mailing Address - Phone:256-533-3314
Mailing Address - Fax:
Practice Address - Street 1:600 SAINT CLAIR AVE SW
Practice Address - Street 2:BUILDING 6
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5008
Practice Address - Country:US
Practice Address - Phone:256-533-3314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist