Individual
LADESSEA MORNAE WOODBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
190 CIVIC CIR STE 210, SUITE 210, LEWISVILLE, TX 75067-3635
(972) 219-1200
Mailing address
210 E WINTERGREEN RD, APT 3204, DESOTO, TX 75115-2496
(469) 652-5125
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2016
Last updated
05/06/2016
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