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Individual

LORRAINE THERESE BURWELL WOODRUFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, BCBA, COBA

Contact information

Practice address
8707 W US HIGHWAY 36, MODOC, IN 47358-9583
(765) 204-2224
Mailing address
970 PLEASANT PLAIN RD E, RICHMOND, IN 47374-9261
(765) 914-6489

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-18-32881
IN
103K00000X
Behavior Analyst
COBA.00501
OH
103TS0200X
School Psychologist
Primary
00001849
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000031849
SCHOOL PSYCHOLOGIST
IN
01
1-18-32881
BCBA CERTIFICATE
05
300021667
IN
Enumeration date
01/02/2019
Last updated
11/18/2025
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