Healthcare Provider Details

I. General information

NPI: 1184066359
Provider Name (Legal Business Name): JAMI LYNN WOOD LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2013
Last Update Date: 07/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 KEELER ST
BOONE IA
50036-2729
US

IV. Provider business mailing address

1619 S HIGH AVE
AMES IA
50010-8055
US

V. Phone/Fax

Practice location:
  • Phone: 866-801-0085
  • Fax:
Mailing address:
  • Phone: 866-801-0085
  • Fax: 515-232-3780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number007956
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: