Provider Demographics
NPI:1366251258
Name:WOODRUFF, JILLIAN P
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:P
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:P
Other - Last Name:BITTENBENDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:724 E GRILL AVE
Mailing Address - Street 2:
Mailing Address - City:SHILLINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19607-2958
Mailing Address - Country:US
Mailing Address - Phone:484-331-4932
Mailing Address - Fax:
Practice Address - Street 1:724 E GRILL AVE
Practice Address - Street 2:
Practice Address - City:SHILLINGTON
Practice Address - State:PA
Practice Address - Zip Code:19607-2958
Practice Address - Country:US
Practice Address - Phone:484-331-4932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty