Individual
CORNELL LAMONT THORN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1003 HUGH WALLIS RD S, LAFAYETTE, LA 70508-2528
(337) 205-4444
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1376101568
LA
Other
Enumeration date
06/03/2019
Last updated
02/17/2020
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