Provider Demographics
NPI:1699840710
Name:ATTWOOD, MARTHA A (PSYD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:A
Last Name:ATTWOOD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:A
Other - Last Name:FERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1680
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25717-1680
Mailing Address - Country:US
Mailing Address - Phone:304-697-1396
Mailing Address - Fax:304-697-2086
Practice Address - Street 1:3377 US ROUTE 60
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-2837
Practice Address - Country:US
Practice Address - Phone:304-399-3310
Practice Address - Fax:304-523-5416
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1001103TC0700X, 103T00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist