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Individual

ROSA CERVANTES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1185 NORWAY ST NE, SALEM, OR 97301-7837
(503) 586-4017
Mailing address
3494 LIBERTY RD S, SALEM, OR 97302-4607
(197) 130-4088

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
A743543
OR

Other

Enumeration date
02/28/2019
Last updated
02/28/2019
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