Individual
KRISTINA WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC-MH SUPERVISION
Contact information
Practice address
102 E 4TH ST, TISHOMINGO, OK 73460-2002
(580) 257-9614
Mailing address
102 E 4TH ST, TISHOMINGO, OK 73460-2002
(580) 257-9614
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/14/2023
Last updated
05/22/2023
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