=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477364446
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CIN WOOD LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2025
-----------------------------------------------------
Last Update Date | 01/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8610 S MARYLAND PKWY APT 1013
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89123-2710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-415-9073
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2381 E WINDMILL LN STE 3
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89123-2069
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-415-9073
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JACINTA WOOD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 702-415-9073
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374J00000X
-----------------------------------------------------
Taxonomy Name | Doula
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------