Individual
MR. ANDREW GIARDINELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BT1
Contact information
Practice address
3709 CITATION WAY STE 102, MEDFORD, OR 97504-9022
(541) 500-6532
Mailing address
3709 CITATION WAY STE 102, MEDFORD, OR 97504-9022
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CA001G9H
—
OR
Enumeration date
01/27/2020
Last updated
01/27/2020
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