Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 8712 | NE |
NPI | 1003065061 |
---|---|
Provider Name | Mrs. Erica M Woodruff |
First Address | Lincoln, NE 68502-3734 |
Second Address | Lincoln, NE 68502-3734 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2008 |
Last Update Date | 14/01/2010 |