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General NPI Number Information
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NPI Number | 1477945525
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Entity Type | Individual
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Provider Name | MARCIE J WOOD LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/26/2015
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 5050 BALTIMORE AVE UNIT 14
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City | PHILADELPHIA
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State | PA
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Zip | 19143-3302
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Country | US
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Telephone | 267-225-5298
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Fax |
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Provider Business Mailing Address
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Address Line | 309 S 51ST ST
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City | PHILADELPHIA
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State | PA
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Zip | 19143-1605
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Country | US
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Telephone | 215-514-5766
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MF000822
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License Number State | PA
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