Provider Demographics
NPI:1417167255
Name:WOOD, CHRISTINA GERMAINE (MT-BC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:GERMAINE
Last Name:WOOD
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2824 TOMAH PL NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-5558
Mailing Address - Country:US
Mailing Address - Phone:507-236-7793
Mailing Address - Fax:
Practice Address - Street 1:2824 TOMAH PL NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-5558
Practice Address - Country:US
Practice Address - Phone:507-236-7793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2014-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN07821225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist