Provider Demographics
NPI:1124460084
Name:WOOD, AMY LYNN (LMFT-I)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNN
Last Name:WOOD
Suffix:
Gender:F
Credentials:LMFT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 SUNBELT CT
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-4550
Mailing Address - Country:US
Mailing Address - Phone:864-354-5957
Mailing Address - Fax:864-286-1111
Practice Address - Street 1:107 SUNBELT CT
Practice Address - Street 2:SUITE 2
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-4550
Practice Address - Country:US
Practice Address - Phone:864-354-5957
Practice Address - Fax:864-286-1111
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-20
Last Update Date:2013-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5545106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist