Provider Demographics
NPI:1366712366
Name:WOOD, DEBORAH LORRAINE (MS, ATC, CSCS, CES)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LORRAINE
Last Name:WOOD
Suffix:
Gender:F
Credentials:MS, ATC, CSCS, CES
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:LORRAINE
Other - Last Name:COBURN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, ATC, CSCS, CES
Mailing Address - Street 1:830 OLD HOMESTEAD HWY
Mailing Address - Street 2:
Mailing Address - City:SWANZEY
Mailing Address - State:NH
Mailing Address - Zip Code:03446-2302
Mailing Address - Country:US
Mailing Address - Phone:603-903-7946
Mailing Address - Fax:
Practice Address - Street 1:830 OLD HOMESTEAD HWY
Practice Address - Street 2:
Practice Address - City:SWANZEY
Practice Address - State:NH
Practice Address - Zip Code:03446-2302
Practice Address - Country:US
Practice Address - Phone:603-903-7946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04292255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer