Wood, Jennifer L

Wood, Jennifer L is an individual health care provider with primary practice located at 2003 Rickety Ln Ste B , Tyler TX 75703-1704. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Wood, Jennifer L can be contacted via phone (903) 283-8729.

Contact Information

Primary practice address
2003 Rickety Ln Ste B Tyler TX 75703-1704
Phone: (903) 283-8729
Fax: (888) 454-9083
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 20344 Texas

Profile Details

NPI number 1588671309
LBN Legal business name Wood, Jennifer L
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2006
Last updated Aug 12th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588671309 NPPES
Other MEDICAID # PENDING

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