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NPI Code Detail

MEDICARE: MS. RENE WOOD LCSW, ACSW

MEDICARE: MS. RENE WOOD LCSW, ACSW
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
11041C0700XClinical Social Worker406WY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1313567OTHERWYBS

General Provider Information

NPI Number : 1164420287
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RENE WOOD LCSW, ACSW
Provider Business Mailing Address
First Line : 1933 E C ST
Second Line :
City : TORRINGTON
State : WY
Zip : 82240-2841
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 501 ALBANY AVE
Second Line :
City : TORRINGTON
State : WY
Zip : 82240-1503
Country : US
Telephone Number : 307-532-4091
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 07/08/2007

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