Provider Demographics
NPI:1275855710
Name:WOOD, JULIE M (MS, PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:M
Last Name:WOOD
Suffix:
Gender:F
Credentials:MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 FEATHERY CIR
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-2816
Mailing Address - Country:US
Mailing Address - Phone:585-264-1562
Mailing Address - Fax:
Practice Address - Street 1:11 FEATHERY CIR
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-2816
Practice Address - Country:US
Practice Address - Phone:585-264-1562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0002731101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health