Individual
COSME JAIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3494 LIBERTY RD S, SALEM, OR 97302-4607
(971) 304-0660
Mailing address
5858 POPPY HILLS ST SE, SALEM, OR 97306-9011
(626) 230-8110
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/04/2019
Last updated
10/04/2019
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