Provider Demographics
NPI:1619271061
Name:WOOD, BRIANNA L (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:BRIANNA
Middle Name:L
Last Name:WOOD
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 BEE CAVE RD
Mailing Address - Street 2:SUITE 508
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6775
Mailing Address - Country:US
Mailing Address - Phone:512-796-5387
Mailing Address - Fax:512-306-0026
Practice Address - Street 1:3355 BEE CAVE RD
Practice Address - Street 2:SUITE 508
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6775
Practice Address - Country:US
Practice Address - Phone:512-796-5387
Practice Address - Fax:512-306-0026
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64707101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional