Carissa Wooddell, MS CCC-SLP | |
1401 E 12th St, Mendota, IL 61342-9216 | |
(815) 539-1409 | |
Not Available |
Full Name | Carissa Wooddell |
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Gender | Female |
Speciality | Speech-language Pathologist |
Location | 1401 E 12th St, Mendota, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699230813 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | 146013301 (Illinois) | Primary |
Provider Name | Empowerme Rehabilitation Illinois Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1679098263 PECOS PAC ID: 2365718277 Enrollment ID: O20171020001353 |
Provider Name | Empowerme Wellness Kansas City Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1174118103 PECOS PAC ID: 9830504836 Enrollment ID: O20210317001954 |
Mailing Address | Practice Location Address |
---|---|
Carissa Wooddell, MS CCC-SLP 26556 N 400 East Rd, Ancona, IL 61311-9805 Ph: (815) 992-0376 | Carissa Wooddell, MS CCC-SLP 1401 E 12th St, Mendota, IL 61342-9216 Ph: (815) 539-1409 |
Mrs. Alicia Foster, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 805 4th Ave, Mendota, IL 61342 Phone: 815-538-6226 | |
Cara Elizabeth Ludwick, M.S., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1309 Jefferson St, Mendota, IL 61342 Phone: 815-539-6888 |