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General NPI Number Information
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NPI Number | 1487361721
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Entity Type | Individual
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Provider Name | MRS. BRIDGET MARIE WOOD
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Gender | Female
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Dates
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Enumeration Date | 11/04/2022
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 102 PROFIT DR
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City | VICTORIA
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State | TX
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Zip | 77901-7346
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Country | US
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Telephone | 361-576-3131
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Fax |
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Provider Business Mailing Address
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Address Line | 217 SPUR DR
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City | VICTORIA
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State | TX
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Zip | 77904-3218
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Country | US
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Telephone | 361-648-3281
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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 | 118719
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License Number State | TX
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