Provider Demographics
NPI:1043665359
Name:WOOD, ANNA BELLE (MA, LPC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:BELLE
Last Name:WOOD
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 JENNINGS MILL RD
Mailing Address - Street 2:3200B
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7244
Mailing Address - Country:US
Mailing Address - Phone:706-248-1042
Mailing Address - Fax:
Practice Address - Street 1:1551 JENNINGS MILL RD
Practice Address - Street 2:3200B
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7244
Practice Address - Country:US
Practice Address - Phone:706-248-1042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008753101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional