Individual
JASHA WOODALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
91 BEACH RD, POUGHQUAG, NY 12570-5133
(845) 625-9052
Mailing address
91 BEACH RD, POUGHQUAG, NY 12570-5133
(845) 625-9052
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-43620
—
Other
Enumeration date
08/19/2020
Last updated
08/19/2020
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