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NPI Code Detail

MEDICARE: YOLANDA M WOOD LCDC

MEDICARE: YOLANDA M WOOD LCDC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor8019TX

General Provider Information

NPI Number : 1083852594
Entity Type Code : Individual
Provider Name (Legal Business Name) : YOLANDA M WOOD LCDC
Provider Business Mailing Address
First Line : 4352 EMMETT F LOWRY EXPY
Second Line :
City : TEXAS CITY
State : TX
Zip : 77591-2628
Country : US
Telephone Number : 409-763-2373
Fax Number :
Provider Business Practice Location Address
First Line : 4352 EMMETT F LOWRY EXPY
Second Line :
City : TEXAS CITY
State : TX
Zip : 77591-2628
Country : US
Telephone Number : 409-763-2373
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2009
Last Update Date : 01/22/2009

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