Provider Demographics
NPI:1538416094
Name:WOOD, AIME Y (MS)
Entity type:Individual
Prefix:MRS
First Name:AIME
Middle Name:Y
Last Name:WOOD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:AIME
Other - Middle Name:Y
Other - Last Name:EBANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1412 TECH BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-7865
Mailing Address - Country:US
Mailing Address - Phone:813-310-4137
Mailing Address - Fax:
Practice Address - Street 1:1412 TECH BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-7865
Practice Address - Country:US
Practice Address - Phone:813-310-4137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRMHI 7200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health