Individual
LORIE LEIGH KOLWYCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3025 WARRIOR LN, POPLAR BLUFF, MO 63901-8685
(573) 686-1200
Mailing address
3025 WARRIOR LN, POPLAR BLUFF, MO 63901-8685
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/08/2025
Last updated
07/08/2025
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