Individual
AMBER SHALISE WOFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5476 SCRUB JAY RUN, PATRICK AFB, FL 32925-2936
(816) 799-2602
Mailing address
5476 SCRUB JAY RUN, PATRICK AFB, FL 32925-2936
(816) 799-2602
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
01/16/2024
Last updated
01/16/2024
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