Individual
CHARLIE JEAN WOFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD BCBA
Contact information
Practice address
1136 KINCAID BRIDGE RD, SUITE A, WINNSBORO, SC 29180-7116
(803) 635-1052
(803) 712-9724
Mailing address
1136 KINCAID BRIDGE RD STE A, WINNSBORO, SC 29180-7116
(803) 635-1052
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
207Q00000X
Family Medicine Physician
Primary
32464
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
324644
—
SC
Enumeration date
07/22/2008
Last updated
08/05/2024
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