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Individual
JEREMY VERN WOODLIFF
Active
Individual
JEREMY VERN WOODLIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4018-226
WI
101YP2500X
Professional Counselor
Primary
8752-125
WI
Other
Enumeration date
09/10/2021
Last updated
01/04/2023
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