| Doctor Name: | KELLE S WOOD |
| NPI Number: | 1164465084 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW |
| License Number: | |
| Business Practice Address: | 3847 Pine Grove Ave Suite A Fort Gratiot, MI - 480594217 |
| Business Phone Number: | 8109854009 |
| Business Fax Number: | 8109848111 |
| Mailing Address: | 555 Colorado Ave, MARYSVILLE |
| State: | MI |
| Postal Code: | 480402545 |
| Phone Number: | 8103643343 |
| Fax Number: | |
| NPI Enumeration Date: | 06/14/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |