Provider Demographics
NPI:1437445491
Name:WOOD, KERRY ANN (BSW)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:ANN
Last Name:WOOD
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3270 SUNTREE BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7530
Mailing Address - Country:US
Mailing Address - Phone:321-610-7949
Mailing Address - Fax:321-610-7947
Practice Address - Street 1:3270 SUNTREE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7530
Practice Address - Country:US
Practice Address - Phone:321-610-7949
Practice Address - Fax:321-610-7947
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker