Provider Demographics
NPI:1174945208
Name:WOODARD, CHERI (OT)
Entity type:Individual
Prefix:
First Name:CHERI
Middle Name:
Last Name:WOODARD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 N BEECH ST
Mailing Address - Street 2:
Mailing Address - City:WOODVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75979-4718
Mailing Address - Country:US
Mailing Address - Phone:409-283-2554
Mailing Address - Fax:409-283-8446
Practice Address - Street 1:102 N BEECH ST
Practice Address - Street 2:
Practice Address - City:WOODVILLE
Practice Address - State:TX
Practice Address - Zip Code:75979-4718
Practice Address - Country:US
Practice Address - Phone:409-283-2554
Practice Address - Fax:409-283-8446
Is Sole Proprietor?:No
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106338225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist