Provider Demographics
NPI:1578136867
Name:WOODRUFF, BAILEY LYNN
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:LYNN
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3611 UNIVERSITY DR APT 2A
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6210
Mailing Address - Country:US
Mailing Address - Phone:302-299-3990
Mailing Address - Fax:
Practice Address - Street 1:1020 SOUTHHILL DR STE 300
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8644
Practice Address - Country:US
Practice Address - Phone:302-299-3990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0165341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical