Individual
ALLAINA DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., BCBA
Contact information
Practice address
32663 BUSH GARDEN DR, HARRISBURG, OR 97446-9751
(503) 296-5396
Mailing address
32663 BUSH GARDEN DR, HARRISBURG, OR 97446-9751
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-25983
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-17-25983
BCBA
—
Enumeration date
09/27/2018
Last updated
09/27/2018
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