Provider Demographics
NPI:1508226846
Name:WOOD, TRICIA ANN (MA, BCBA)
Entity Type:Individual
Prefix:MISS
First Name:TRICIA
Middle Name:ANN
Last Name:WOOD
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 JESSICA CT
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-5043
Mailing Address - Country:US
Mailing Address - Phone:707-498-9041
Mailing Address - Fax:
Practice Address - Street 1:1745 JESSICA CT
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-5043
Practice Address - Country:US
Practice Address - Phone:707-498-9041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst