Provider Demographics
NPI:1194864082
Name:WOOD, DANIEL LOUIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:LOUIS
Last Name:WOOD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 WHITE BRIDGE RD
Mailing Address - Street 2:SUITE 415
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-1497
Mailing Address - Country:US
Mailing Address - Phone:615-356-5105
Mailing Address - Fax:615-353-1073
Practice Address - Street 1:95 WHITE BRIDGE RD
Practice Address - Street 2:SUITE 415
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-1497
Practice Address - Country:US
Practice Address - Phone:615-356-5105
Practice Address - Fax:615-353-1073
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1929103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3980341Medicare ID - Type UnspecifiedMEDICARE ID