Individual
MATT WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED, BCBA
Contact information
Practice address
419 WHITEWATER DR, IRMO, SC 29063-7851
(919) 805-2098
Mailing address
419 WHITEWATER DR, IRMO, SC 29063-7851
(919) 805-2098
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-10-7795
FL
Other
Enumeration date
01/27/2011
Last updated
01/27/2011
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