Provider Demographics
NPI:1093206013
Name:WOOD, SCOTT (LPA)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:WOOD
Suffix:
Gender:M
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 DAVIS MOUNTAIN LOOP
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7466
Mailing Address - Country:US
Mailing Address - Phone:254-423-2819
Mailing Address - Fax:
Practice Address - Street 1:1421 DAVIS MOUNTAIN LOOP
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7466
Practice Address - Country:US
Practice Address - Phone:254-423-2819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
TX2252103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst