Provider Demographics
NPI:1588971154
Name:WOODS, MILEEN KEON (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:MILEEN
Middle Name:KEON
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 1:6710 PLANTERS DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-7983
Mailing Address - Country:US
Mailing Address - Phone:336-772-5334
Mailing Address - Fax:
Practice Address - Street 1:6710 PLANTERS DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-7983
Practice Address - Country:US
Practice Address - Phone:336-772-5334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-02
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9398235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
23OtherSPEECH LANGUAGE PATHOLOGY