Individual
CODY O'CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
522 W RIVERSIDE AVE STE 4691, SPOKANE, WA 99201-0580
(360) 605-0163
Mailing address
1223 VIEW AVE, CENTRALIA, WA 98531-1823
(509) 699-1494
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB61001207
WA
Other
Enumeration date
02/06/2024
Last updated
02/06/2024
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