Provider Demographics
NPI:1114141017
Name:WOOD, RHONDA ANN (SLPCCC)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:ANN
Last Name:WOOD
Suffix:
Gender:F
Credentials:SLPCCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 ALPENDORF AVE
Mailing Address - Street 2:
Mailing Address - City:READSBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05350-9509
Mailing Address - Country:US
Mailing Address - Phone:802-423-7715
Mailing Address - Fax:
Practice Address - Street 1:25 MARSHALL ST
Practice Address - Street 2:BRIEN CENTER
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2451
Practice Address - Country:US
Practice Address - Phone:413-398-1341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3697235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist