Individual
NICOLE WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
10820 SUNSET OFFICE DR, SUITE 108, SAINT LOUIS, MO 63127-1016
(314) 956-9869
Mailing address
204 N 38TH ST, BELLEVILLE, IL 62226-6024
(618) 443-8023
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2007034751
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
494057805
—
MO
Enumeration date
01/31/2008
Last updated
05/16/2008
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