Provider Demographics
NPI:1316299951
Name:WOODBURY, ALYSON (MS, CFY-SLP)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:WOODBURY
Suffix:
Gender:F
Credentials:MS, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14007 S 34TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-7070
Mailing Address - Country:US
Mailing Address - Phone:480-225-1850
Mailing Address - Fax:
Practice Address - Street 1:14007 S 34TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-7070
Practice Address - Country:US
Practice Address - Phone:480-225-1850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP8013235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist