Provider Demographics
NPI:1386717866
Name:WOOD, GEORGANNE G (MA, LMFT)
Entity type:Individual
Prefix:MRS
First Name:GEORGANNE
Middle Name:G
Last Name:WOOD
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 SPRINGPOINTE WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-4471
Mailing Address - Country:US
Mailing Address - Phone:865-692-5179
Mailing Address - Fax:865-692-5179
Practice Address - Street 1:1425 SPRINGPOINTE WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-4471
Practice Address - Country:US
Practice Address - Phone:865-692-5179
Practice Address - Fax:865-692-5179
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLMT0000000614106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist