Provider Demographics
NPI:1942453881
Name:WOOD, SANDRA RENE (LPC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:RENE
Last Name:WOOD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WINCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-2701
Mailing Address - Country:US
Mailing Address - Phone:512-801-2460
Mailing Address - Fax:512-264-3234
Practice Address - Street 1:110 WINCHESTER DR
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-2701
Practice Address - Country:US
Practice Address - Phone:512-801-2460
Practice Address - Fax:512-264-3234
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62599101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional