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Individual
THEODORE ROY WOODRUFF
Active
Individual
THEODORE ROY WOODRUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
14-CRM-024
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-20-391
OR
175T00000X
Peer Specialist
THW000000864
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14-CRM-024
MHACBO CRM
OR
05
—
500609571
—
OR
Enumeration date
09/20/2017
Last updated
03/04/2026
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