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General NPI Number Information
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NPI Number | 1831480029
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Entity Type | Organization
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Legal Business Name | FRANK D. R. WOOD PH.D. LLC
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Dates
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Enumeration Date | 04/22/2011
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Last Update Date | 04/22/2011
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Provider Practice Location Address
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Address Line | 12 WALNUT AVE
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City | WYOMING
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State | OH
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Zip | 45215-4336
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Country | US
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Telephone | 513-381-6611
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Fax | 513-381-7818
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Provider Business Mailing Address
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Address Line | 12 WALNUT AVENUE
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City | CINCINNATI
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State | OH
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Zip | 45215
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Country | US
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Telephone | 513-381-6611
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Fax | 513-381-7818
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | FRANK WOOD
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Credential | PHD
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Telephone | 513-381-6611
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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 | 6482
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License Number State | OH
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