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Individual

BENNETT WOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
280 CHARLOIS BLVD, WINSTON SALEM, NC 27103-1588
(704) 799-6824
Mailing address
2136 SHACKTOWN RD, YADKINVILLE, NC 27055-8113
(615) 560-6622

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
08/11/2026
Last updated
08/11/2026
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