Doctor Name: | MR. KEVIN N. WOOD |
NPI Number: | 1780747477 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MMFT,LPC |
License Number: | |
Business Practice Address: | 501 S. Burma Avenue Gillette, WY - 827173011 |
Business Phone Number: | 3076885000 |
Business Fax Number: | 3076885015 |
Mailing Address: | 3204 Crestline Circle, GILLETTE |
State: | WY |
Postal Code: | 82716 |
Phone Number: | 3076885000 |
Fax Number: | 3076885015 |
NPI Enumeration Date: | 12/18/2006 |
NPI Last Update Date: | 06/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |