Provider Demographics
NPI:1760242408
Name:WOOD, DEBORAH (LMFT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13505 COLETO CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-2073
Mailing Address - Country:US
Mailing Address - Phone:415-827-1421
Mailing Address - Fax:
Practice Address - Street 1:13505 COLETO CREEK TRL
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-2073
Practice Address - Country:US
Practice Address - Phone:415-827-1421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40092106H00000X
TX203124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist