Individual
LORENZO ANDRES TELLERIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11606 SOUTHFORK AVE STE 300B, BATON ROUGE, LA 70816-5235
(225) 292-5981
Mailing address
21600 OXNARD ST STE 1899, WOODLAND HILLS, CA 91367-4976
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8701343320272
—
LA
Enumeration date
10/11/2018
Last updated
10/11/2018
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