Provider Demographics
NPI:1639402449
Name:WOOD, DENISE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:PO BOX 314
Mailing Address - Street 2:7473 N GREGORY RD
Mailing Address - City:FOWLERVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48836-0314
Mailing Address - Country:US
Mailing Address - Phone:517-223-8675
Mailing Address - Fax:
Practice Address - Street 1:7473 N GREGORY RD
Practice Address - Street 2:
Practice Address - City:FOWLERVILLE
Practice Address - State:MI
Practice Address - Zip Code:48836-8737
Practice Address - Country:US
Practice Address - Phone:517-223-8675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2023-05-26
Deactivation Date:2015-10-02
Deactivation Code:
Reactivation Date:2023-05-26
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist