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General NPI Number Information
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NPI Number | 1063661064
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Entity Type | Individual
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Provider Name | KRISTIN A WOOD M.S., CCC-SLP/L
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Gender | Female
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Dates
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Enumeration Date | 09/15/2008
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 92 RIVERVIEW CT
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City | GRAND ISLAND
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State | NY
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Zip | 14072-2852
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Country | US
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Telephone | 716-998-6092
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Fax |
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Provider Business Mailing Address
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Address Line | 6080 STRICKLER RD
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City | CLARENCE
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State | NY
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Zip | 14031-1025
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Country | US
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Telephone | 716-913-5794
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 017011
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License Number State | NY
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