Individual
AUDREY ROGOVIN WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
19 ELM ST, MAYNARD, MA 01754-2628
(978) 844-2717
Mailing address
729 BOYLSTON ST FL 5, BOSTON, MA 02116-2639
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000226125
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000226125
SOCIAL WORK LICENSE
MA
Enumeration date
04/09/2021
Last updated
04/09/2021
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