MEDICARE: DR. BARBARA LOUISE WOOD PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	0128	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0128	OTHER	MD	LICENSE NUMBER

General Provider Information

NPI Number	:	1952427676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA LOUISE WOOD PH.D.

Provider Business Mailing Address
First Line	:	4915 SAINT ELMO AVE
Second Line	:	SUITE 404
City	:	BETHESDA
State	:	MD
Zip	:	20814-6019
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4915 SAINT ELMO AVE
Second Line	:	SUITE 404
City	:	BETHESDA
State	:	MD
Zip	:	20814-6019
Country	:	US
Telephone Number	:	301-652-4147
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	07/08/2007

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