Healthcare Provider Details

I. General information

NPI: 1326141573
Provider Name (Legal Business Name): JENNIFER ALLISON WOOD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 TREASURE HILLS BLVD VA OUTPATIENT CLINIC
HARLINGEN TX
78550-8907
US

IV. Provider business mailing address

1629 TREASURE HILLS BLVD VA OUTPATIENT CLINIC
HARLINGEN TX
78550-8907
US

V. Phone/Fax

Practice location:
  • Phone: 956-366-4500
  • Fax: 956-366-4501
Mailing address:
  • Phone: 956-366-4500
  • Fax: 956-366-4501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number33024
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: