Provider Demographics
NPI:1386315836
Name:WOOD, PRYNDANA (CBT, RBT)
Entity type:Individual
Prefix:
First Name:PRYNDANA
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:CBT, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10310 26TH PL SE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-5669
Mailing Address - Country:US
Mailing Address - Phone:425-248-5222
Mailing Address - Fax:
Practice Address - Street 1:10310 26TH PL SE
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-5669
Practice Address - Country:US
Practice Address - Phone:425-248-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician