Provider Demographics
NPI:1821580614
Name:WOFFORD, SUSAN JILL (OTR)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:JILL
Last Name:WOFFORD
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7144 VIRGINIA LAMM DR
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27253-9820
Mailing Address - Country:US
Mailing Address - Phone:336-693-5962
Mailing Address - Fax:
Practice Address - Street 1:323 BALDWIN RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-2715
Practice Address - Country:US
Practice Address - Phone:336-229-5571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6204225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation