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Jodi Willis
Developmental Disabilities Clinic/Center in Raeford, North Carolina
NPI 1912186792

Jodi Willis is a Developmental Disabilities Clinic/Center based in Raeford, NC and is specialized in Developmental Disabilities. Jodi Willis practices in Raeford, NC. The NPI Number for Jodi Willis is 1912186792 and holds a License No. (North Carolina).

The current practice location address for Jodi Willis is 305 Wooley St, Raeford, NC and can be reached out via phone at 910-875-5074 and via fax at 910-875-7694.

Location: 305 Wooley St, Raeford, NC, 28376-3236
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1912186792
Provider Name
Jodi Willis
Credential
Provider Entity Type
Individual
Gender
Female
Address
305 Wooley St, Raeford, NC, 28376-3236
Phone Number
910-875-5074
Fax Number
910-875-7694
Provider Enumeration Date
10/30/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8300027K 05 NC
institution
Provider Business Practice Location Address Details
Address
305 Wooley St
City
Raeford
State
North Carolina
Zip
28376-3236
Phone Number
910-875-5074
Fax Number
910-875-7694
person
Provider Business Mailing Address Details
Address
305 Wooley St
City
Raeford
State
North Carolina
Zip
28376-3236
Phone Number
910-875-5074
Fax Number
910-875-7694
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Developmental Disabilities
Taxonomy
261QD1600X
License No.
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Definition
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
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