Most Relevant Information
Provider Data
| NPI Number: | 1003539651 |
| Provider Name: | KORRIE WOODRUFF RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-22-234837 |
Most Important Dates
| Enumeration Date: | 09/20/2022 |
| Last Updated: | 09/20/2022 |
Provider Practice Location
6033 FASHION POINT DR
SOUTH OGDEN
UT
844034847
Practice Location Phone/Fax
| Phone: | 8015498821 |
| Fax: |
Provider Mailing Location
1105 W RUSSELL ST
SIOUX FALLS
SD
571041322
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |