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General NPI Number Information
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NPI Number | 1437294485
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Entity Type | Individual
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Provider Name | ELAINE M WOOD PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 04/27/2009
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Provider Practice Location Address
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Address Line | 226 W KYTLE ST SUITE B
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City | CLEVELAND
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State | GA
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Zip | 30528-1332
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Country | US
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Telephone | 706-219-1998
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Fax | 706-219-2038
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Provider Business Mailing Address
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Address Line | PO BOX 3080
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City | CLEVELAND
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State | GA
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Zip | 30528-0054
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Country | US
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Telephone | 706-219-2038
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Fax | 706-219-2038
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY01744
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License Number State | GA
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