Provider Demographics
NPI:1578622668
Name:WOOD, DEMIAN PATRICIA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:DEMIAN
Middle Name:PATRICIA
Last Name:WOOD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:ELLEN
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1218 HAWKEYE CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-8831
Mailing Address - Country:US
Mailing Address - Phone:970-206-4472
Mailing Address - Fax:206-350-3364
Practice Address - Street 1:1218 HAWKEYE CT
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-8831
Practice Address - Country:US
Practice Address - Phone:970-206-4472
Practice Address - Fax:206-350-3364
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO706106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist