Individual
MS. MYRA ELAINE WOODRUFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
3 MAIN ST, SUITE 216, BURLINGTON, VT 05401-5216
(802) 651-2318
(801) 899-4880
Mailing address
18 OUTLOOK LN, JERICHO, VT 05465-2532
(802) 861-2318
(802) 899-4880
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890000919
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009230
—
VT
Enumeration date
06/03/2006
Last updated
02/02/2008
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