Basic Information
| Provider Information | |||||||||
| NPI: | 1255454369 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | WOOD | ||||||||
| FirstName: | BROWNEN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 180 GRAFTON LANE | ||||||||
| Address2: | |||||||||
| City: | BERRYVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226113142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405420200 | ||||||||
| FaxNumber: | 5405420218 | ||||||||
| Practice Location | |||||||||
| Address1: | 180 GRAFTON LANE | ||||||||
| Address2: | |||||||||
| City: | BERRYVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405420200 | ||||||||
| FaxNumber: | 5405420218 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2007 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225A00000X | 07189 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Music Therapist |
No ID Information.