| Marie W. Wood Phd Inc | |
|
215 N East Ave Fayetteville AR 72701-5296 | |
| (479) 521-9696 | |
| Not Available |
| Full Name | Marie W. Wood Phd Inc |
|---|---|
| Speciality | Psychologist |
| Location | 215 N East Ave, Fayetteville, Arkansas |
| Authorized Official Name and Position | Terry Borman (BILLING MANAGER) |
| Authorized Official Contact | 4792363221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marie W. Wood Phd Inc Po Box 4808 Fayetteville AR 72702-4808 Ph: (479) 236-3221 | Marie W. Wood Phd Inc 215 N East Ave Fayetteville AR 72701-5296 Ph: (479) 521-9696 |
| NPI Number | 1003438086 |
|---|---|
| Provider Enumeration Date | 05/12/2020 |
| Last Update Date | 05/12/2020 |
| Certification Date | 05/12/2020 |
| Medicare PECOS PAC ID | 2769813013 |
|---|---|
| Medicare Enrollment ID | O20200520002891 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003438086 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Marie W Wood |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942257563 PECOS PAC ID: 1153306386 Enrollment ID: I20080102000649 |
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