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General NPI Number Information
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NPI Number | 1942397203
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Entity Type | Individual
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Provider Name | EDWARD WOOD RUFFIN LCSW
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Gender | Male
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 05/18/2012
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Provider Practice Location Address
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Address Line | 175 EMERY HIGHWAY
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City | MACON
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State | GA
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Zip | 31217
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Country | US
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Telephone | 478-803-7631
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Fax | 478-751-4530
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Provider Business Mailing Address
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Address Line | 175 EMERY HIGHWAY
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City | MACON
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State | GA
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Zip | 31217
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Country | US
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Telephone | 478-803-7631
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Fax | 478-751-4430
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 001481
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License Number State | GA
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