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Individual

ADDISON GRACE BODYFELT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
14724 VENTURA BLVD STE 1105, SHERMAN OAKS, CA 91403-3510
(747) 298-3480
Mailing address
9151 DARBY AVE APT 101, NORTHRIDGE, CA 91325-2251
(916) 699-6880

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
02/21/2025
Last updated
12/04/2025
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