Provider Demographics
NPI:1902604382
Name:WOOD, AMBER DANIALLE
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:DANIALLE
Last Name:WOOD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:DANIALLE
Other - Last Name:DRIMMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1649 61ST ST FL 3013
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-2110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1013 PARK ST
Practice Address - Street 2:
Practice Address - City:LARNED
Practice Address - State:KS
Practice Address - Zip Code:67550-2333
Practice Address - Country:US
Practice Address - Phone:913-426-4839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst