Provider Demographics
NPI:1982429874
Name:WOOD, SHAYLA
Entity type:Individual
Prefix:MRS
First Name:SHAYLA
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SHAYLA
Other - Middle Name:
Other - Last Name:ELSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:842 SANDY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WV
Mailing Address - Zip Code:26354-7276
Mailing Address - Country:US
Mailing Address - Phone:304-641-6877
Mailing Address - Fax:
Practice Address - Street 1:842 SANDY CREEK RD
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WV
Practice Address - Zip Code:26354-7276
Practice Address - Country:US
Practice Address - Phone:304-641-6877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency