Individual
MARY JOAN WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHS CCC SLP
Contact information
Practice address
501 WEST SHORE DRIVE, CAIRO, MO 65239
(660) 295-4278
Mailing address
PO BOX 115, CAIRO, MO 65239-0115
(660) 295-4278
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
115037
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
464741008
—
MO
05
—
464741016
—
MO
05
—
464741024
—
MO
05
—
855258703
—
MO
Enumeration date
06/13/2007
Last updated
07/01/2008
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