Organization
SPECTRUM POWERED, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE NICOLE WIEMHOLT BOBA (OWNER)
(805) 874-2142
Entity
Organization
Contact information
Practice address
1135 HYDE PARK PLACE, EURGENE, OR 97401
(805) 874-2142
Mailing address
1135 HYDE PARK PLACE, EURGENE, OR 97401
(805) 874-2142
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
225800000X
Recreation Therapist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
06/20/2022
Last updated
06/20/2022
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