Individual
ALLY JO CLODFELTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
711 E MAIN ST STE 14, MEDFORD, OR 97504-7139
(818) 345-2345
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
3601603301512913
TN
Other
Enumeration date
05/14/2018
Last updated
05/14/2018
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