Provider Demographics
NPI:1003092354
Name:WOOD, WILLIAM PAUL (MA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:PAUL
Last Name:WOOD
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 JOHN MARSHALL DRIVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25755
Mailing Address - Country:US
Mailing Address - Phone:304-696-3641
Mailing Address - Fax:304-696-2986
Practice Address - Street 1:1 JOHN MARSHALL DRIVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25755
Practice Address - Country:US
Practice Address - Phone:304-696-3641
Practice Address - Fax:304-696-2986
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP-0873235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV7405090000Medicaid