Provider Demographics
NPI:1205119757
Name:WOOD, JOVANA RADOVIC (LMFT)
Entity type:Individual
Prefix:MRS
First Name:JOVANA
Middle Name:RADOVIC
Last Name:WOOD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JOVANA
Other - Middle Name:
Other - Last Name:RADOVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:4530 UNION BAY PLACE NE
Mailing Address - Street 2:SUITE 214
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105
Mailing Address - Country:US
Mailing Address - Phone:206-420-7345
Mailing Address - Fax:206-829-9678
Practice Address - Street 1:4530 UNION BAY PLACE NE
Practice Address - Street 2:SUITE 214
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105
Practice Address - Country:US
Practice Address - Phone:206-420-7345
Practice Address - Fax:206-829-9678
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG60235851390200000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program