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Individual
DR. KEVIN MICHAEL WOOD
Active
Individual
DR. KEVIN MICHAEL WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
622
IA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
00622
IA
103TH0004X
Health Psychologist
00210
IA
103TS0200X
School Psychologist
00622
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0459529
—
IA
01
—
31342
UNKNOWN
IA
Enumeration date
11/13/2006
Last updated
04/29/2010
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