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Individual

DR. LORENZO ADRIAN WOODSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
121 W WYNEVA ST, PHILADELPHIA, PA 19144-3631
(267) 632-1068
Mailing address
121 WEST WYNEVA STREET, PHILADELPHIA, PA 19144
(267) 632-1068

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH000181
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
821253172
PA
Enumeration date
03/19/2015
Last updated
07/09/2024
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