Individual
CAROL DENISE WOODVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M,OTR/L
Contact information
Practice address
913 HORNE DRIVE, BENTON CITY, WA 99320
(509) 588-2090
Mailing address
2177 MORENCY DR, RICHLAND, WA 99352-9516
(208) 317-4440
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT00003399
WA
Other
Enumeration date
12/05/2017
Last updated
12/05/2017
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