Individual
GEORGE RAYMOND WOODRUFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
792
SC
103TB0200X
Cognitive & Behavioral Psychologist
792
SC
103TC0700X
Clinical Psychologist
Primary
792
SC
103TC2200X
Clinical Child & Adolescent Psychologist
792
SC
103TF0000X
Family Psychologist
792
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS0317
—
SC
Enumeration date
05/17/2006
Last updated
03/24/2017
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