Individual
JEREMIAH WOODRUFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
859 S YELLOWSTONE HWY STE 302, REXBURG, ID 83440-5294
(208) 557-1227
Mailing address
153 N 3988 E, RIGBY, ID 83442-5310
(480) 603-8905
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2271392
ID
101YP2500X
Professional Counselor
Primary
2271392
ID
Other
Enumeration date
01/06/2026
Last updated
03/06/2026
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