Sydney Jade Woodman, SLP

Individual provider Active NPI Speech-Language Pathologist · Grand Rapids, MI

NPI 1144812025 · NPPES record last updated May 31, 2024

Key facts

NPI
1144812025
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
7101008245 (MI)
Practice address
235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone
(616) 840-8000
NPI assigned
Feb 11, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Northern PT, LLC Past
since Feb 1, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7101008245 MI Yes

Addresses

Primary practice location

235 Wealthy St SE
Grand Rapids, MI 49503-5247

Mailing address

235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone (616) 840-7135

Other providers in Grand Rapids, MI

All providers in Grand Rapids, MI · Speech-Language Pathologist in Michigan

Sources for this page

Verify at the official NPI Registry.