Individual
MRS. JENNIFER D WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
50 NORTH MEDICAL DRIVE, SALT LAKE, UT 84132
(801) 339-1585
Mailing address
2727 S 625 W APT H303, BOUNTIFUL, UT 84010-8284
(801) 699-6556
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5172348-4102
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5172348-4102
STATE LICENSE
UT
Enumeration date
05/14/2007
Last updated
07/08/2007
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