Provider Demographics
NPI:1821381872
Name:WOOD, SHEILA LYNN (MFTI)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:LYNN
Last Name:WOOD
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72710 E LYNN ST
Mailing Address - Street 2:
Mailing Address - City:THOUSAND PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92276-3312
Mailing Address - Country:US
Mailing Address - Phone:760-343-3211
Mailing Address - Fax:
Practice Address - Street 1:72710 E LYNN ST
Practice Address - Street 2:
Practice Address - City:THOUSAND PALMS
Practice Address - State:CA
Practice Address - Zip Code:92276-3312
Practice Address - Country:US
Practice Address - Phone:760-343-3211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61930106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist