Provider Demographics
NPI:1063677219
Name:WOOD, DANIELLE (MS)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 TATUM ST
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-3499
Mailing Address - Country:US
Mailing Address - Phone:856-845-8050
Mailing Address - Fax:
Practice Address - Street 1:404 TATUM ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-3499
Practice Address - Country:US
Practice Address - Phone:856-845-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-26
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health