Healthcare Provider Details

I. General information

NPI: 1134360415
Provider Name (Legal Business Name): ARNOLD F WOODRUFF M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2009
Last Update Date: 03/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4805 RODNEY RD
RICHMOND VA
23230-2508
US

IV. Provider business mailing address

4805 RODNEY RD
RICHMOND VA
23230-2508
US

V. Phone/Fax

Practice location:
  • Phone: 804-358-4249
  • Fax: 804-819-4263
Mailing address:
  • Phone: 804-358-4249
  • Fax: 804-819-4263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717000084
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: