Provider Demographics
NPI:1801130414
Name:WOOD, ALICIA J (OT/L)
Entity type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:J
Last Name:WOOD
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 WINDWARD LN
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-4742
Mailing Address - Country:US
Mailing Address - Phone:603-533-8308
Mailing Address - Fax:
Practice Address - Street 1:40 CROSBY ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-4707
Practice Address - Country:US
Practice Address - Phone:603-673-7061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1531225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist