Provider Demographics
NPI:1134827181
Name:WOOD, NEKESHA NICOLE
Entity type:Individual
Prefix:
First Name:NEKESHA
Middle Name:NICOLE
Last Name:WOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-6720
Mailing Address - Country:US
Mailing Address - Phone:304-650-5925
Mailing Address - Fax:
Practice Address - Street 1:611 WILLOW ST
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-6720
Practice Address - Country:US
Practice Address - Phone:304-650-5925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician