Doctor Name: | MRS. CAROLYN HENNESSEY-WOOD |
NPI Number: | 1710283940 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A.,C.C.C. |
License Number: | |
Business Practice Address: | 28850 Haas Rd Wixom, MI - 483933017 |
Business Phone Number: | 5868170252 |
Business Fax Number: | |
Mailing Address: | 8070 Perry Lake Rd, CLARKSTON |
State: | MI |
Postal Code: | 483484647 |
Phone Number: | 2486257240 |
Fax Number: | |
NPI Enumeration Date: | 02/05/2011 |
NPI Last Update Date: | 02/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |