Provider Demographics
NPI:1174847792
Name:WOOD, EMILY ALYSON (BS)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ALYSON
Last Name:WOOD
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ALYSON
Other - Last Name:SOLLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:917 ASPEN CT
Mailing Address - Street 2:
Mailing Address - City:NOBLE
Mailing Address - State:OK
Mailing Address - Zip Code:73068-9325
Mailing Address - Country:US
Mailing Address - Phone:580-465-4468
Mailing Address - Fax:
Practice Address - Street 1:917 ASPEN CT
Practice Address - Street 2:
Practice Address - City:NOBLE
Practice Address - State:OK
Practice Address - Zip Code:73068-9325
Practice Address - Country:US
Practice Address - Phone:580-465-4468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)