Individual
HOLLY LULAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, QMHA
Contact information
Practice address
530 NW 27TH ST, CORVALLIS, OR 97330-5223
(541) 766-6734
Mailing address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
OR
Other
Enumeration date
03/02/2017
Last updated
11/25/2019
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