Individual
MS. LECIA RENEE BUTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
912 NE KELLY AVE, GRESHAM, OR 97030-5629
(503) 912-5502
Mailing address
21600 OXNARD ST STE 100C, WOODLAND HILLS, CA 91367-4976
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
4295078
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FH23884C
—
OR
Enumeration date
10/04/2018
Last updated
10/04/2018
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