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General NPI Number Information
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NPI Number | 1568934552
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Entity Type | Individual
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Provider Name | LORRAINE THERESE BURWELL WOODRUFF MS, BCBA, COBA
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Gender | Female
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Dates
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Enumeration Date | 01/02/2019
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 8707 W US HIGHWAY 36
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City | MODOC
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State | IN
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Zip | 47358-9583
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Country | US
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Telephone | 765-204-2224
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Fax |
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Provider Business Mailing Address
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Address Line | 970 PLEASANT PLAIN RD E
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City | RICHMOND
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State | IN
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Zip | 47374-9261
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Country | US
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Telephone | 765-914-6489
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-18-32881
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 00001849
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | COBA.00501
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License Number State | OH
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