Healthcare Provider Details

I. General information

NPI: 1366439440
Provider Name (Legal Business Name): WENDY JO-AN WOOD MS NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 GETTYSBURG PIKE
MECHANICSBURG PA
17055-5169
US

IV. Provider business mailing address

200 NORTH 7TH ST
LEBANON PA
17046
US

V. Phone/Fax

Practice location:
  • Phone: 717-795-8363
  • Fax: 717-796-1466
Mailing address:
  • Phone: 717-273-1710
  • Fax: 717-273-1416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number79846
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: