Healthcare Provider Details

I. General information

NPI: 1659995165
Provider Name (Legal Business Name): PENELOPE ROSE WOOD ASSOCIATE COUNSELOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PENELOPE ROSE SANCHEZ ASSOCIATE COUNSELOR

II. Dates (important events)

Enumeration Date: 05/31/2020
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 RAILWAY AVE
SEWARD AK
99664-0999
US

IV. Provider business mailing address

302 RAILWAY AVE
SEWARD AK
99664-0999
US

V. Phone/Fax

Practice location:
  • Phone: 907-224-5257
  • Fax:
Mailing address:
  • Phone: 907-224-5257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: