Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 17-24P | AR |
Y | 103T00000X | Psychologist | 17-24P | AR |
N | 103TS0200X | School Psychologist | 17-24P | AR |
NPI | 1013408137 |
---|---|
Provider Name | Dr. Mara Elizabeth Wood |
First Address | Springdale, AR 72762 |
Second Address | Springdale, AR 72762 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2018 |
Last Update Date | 13/09/2021 |