Individual
LONELL WOODHOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IS
Contact information
Practice address
106 MOUNTAIN DR, POCATELLO, ID 83204-4723
(562) 731-9705
Mailing address
16732 CEDARWOOD CIR, CERRITOS, CA 90703-2845
(562) 802-3558
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/30/2021
Last updated
12/30/2021
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