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General NPI Number Information
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NPI Number | 1265609093
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Entity Type | Organization
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Legal Business Name | GRANT AND EMMA WOOD LLC
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 6710 W 121ST ST
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City | OVERLAND PARK
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State | KS
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Zip | 66209-2002
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Country | US
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Telephone | 913-647-8092
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Fax | 913-647-8088
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Provider Business Mailing Address
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Address Line | 6710 W 121ST ST
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City | OVERLAND PARK
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State | KS
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Zip | 66209-2002
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Country | US
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Telephone | 913-647-8092
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Fax | 913-647-8088
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GRANT WOOD
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Credential | LCMFT
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Telephone | 913-647-8092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LCMFT 269
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License Number State | KS
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