# DR. KEVIN MICHAEL WOOD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1437220365
- **Gender:** Man
- **Credential:** PH.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | 622 | IA | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 00622 | IA | Yes |
| 103TH0004X | Health Psychologist | 00210 | IA | — |
| 103TS0200X | School Psychologist | 00622 | IA | — |

## Other

- **Enumeration date:** 11/13/2006
- **Last updated:** 04/29/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0459529 | — | IA |
| 01 | — | 31342 | UNKNOWN | IA |