MEDICARE: MRS. EMILY WOOD M.S.,CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	2010013279	MO

General Provider Information

NPI Number	:	1235418179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMILY WOOD M.S.,CCC-SLP

Provider Business Mailing Address
First Line	:	21578 LAWRENCE 1074
Second Line	:
City	:	MONETT
State	:	MO
Zip	:	65708-8268
Country	:	US
Telephone Number	:	479-426-8003
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 N MYRTLE ST
Second Line	:
City	:	PIERCE CITY
State	:	MO
Zip	:	65723-1124
Country	:	US
Telephone Number	:	417-476-2555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2011
Last Update Date	:	03/19/2019

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Directions to “ MRS. EMILY WOOD M.S.,CCC-SLP” Practice Location

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