Individual
DR. KEVIN MICHAEL WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
200 HAWKINS DR, 2525 JCP, IOWA CITY, IA 52242-1009
(319) 384-9977
(319) 353-7986
Mailing address
200 HAWKINS DR, 2525 JCP, IOWA CITY, IA 52242-1009
(319) 384-9977
(319) 353-7986
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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