Most Relevant Information
Provider Data
  | NPI Number: | 1003549882 | 
| Provider Name: | JILL LEEAN WOODRUM | 
| Entity Type: | Individual | 
| Taxonomy Code: | 101YA0400X | 
| Specialty: | Counselor | 
| License Number: | 
Most Important Dates
  | Enumeration Date: | 07/08/2022 | 
| Last Updated: | 07/08/2022 | 
Provider Practice Location
  2157 GREENBRIER ST
      
      CHARLESTON
      WV
      253119623
  Practice Location Phone/Fax
      | Phone: | 3043445924 | 
| Fax: | 
Provider Mailing Location
  2157 GREENBRIER ST
      
      CHARLESTON
      WV
      253119623
  Provider Mailing Phone/Fax
      | Phone: | 3043445924 | 
| Fax: |