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NPI Code Detail

MEDICARE: JENNIFER K WOOD LCPC

MEDICARE: JENNIFER K WOOD LCPC
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
1101YP2500XProfessional Counselor59439MT

General Provider Information

NPI Number : 1477264224
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER K WOOD LCPC
Provider Business Mailing Address
First Line : PO BOX 2261
Second Line :
City : BIGFORK
State : MT
Zip : 59911-2261
Country : US
Telephone Number : 406-261-2131
Fax Number :
Provider Business Practice Location Address
First Line : 7935 MT HIGHWAY 35 STE 202
Second Line :
City : BIGFORK
State : MT
Zip : 59911-5711
Country : US
Telephone Number : 406-261-2131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2022
Last Update Date : 12/12/2022

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