Provider Demographics
NPI:1346585007
Name:WOOD, BRANDI MCGINNIS (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:MCGINNIS
Last Name:WOOD
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:373 HIDDEN CREEK LN
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-1285
Mailing Address - Country:US
Mailing Address - Phone:404-218-1442
Mailing Address - Fax:
Practice Address - Street 1:373 HIDDEN CREEK LN
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-1285
Practice Address - Country:US
Practice Address - Phone:404-218-1442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006697235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist