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General NPI Number Information
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NPI Number | 1225997802
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Entity Type | Individual
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Provider Name | VINCENT STUART WOODRUFF
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Gender | Male
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 2018 HOMESITE DR
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City | DAYTON
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State | OH
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Zip | 45414-4020
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Country | US
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Telephone | 937-271-9708
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 GREENOB DR
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City | ENGLEWOOD
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State | OH
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Zip | 45322-2208
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Country | US
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Telephone | 937-271-9708
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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