Individual
MRS. JENNIFER L WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2003 RICKETY LN STE B, TYLER, TX 75703-1704
(903) 283-8729
(888) 454-9083
Mailing address
2003 RICKETY LN STE B, TYLER, TX 75703-1704
(903) 283-8729
(888) 454-9083
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
20344
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MEDICAID #
PENDING
—
Enumeration date
08/02/2006
Last updated
08/12/2013
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