Individual
OLIVIA CUDDEFORD, BAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18765 SW BOONES FERRY RD STE 100, TUALATIN, OR 97062-8607
(503) 612-1000
Mailing address
18765 SW BOONES FERRY RD STE 100, TUALATIN, OR 97062-8607
(503) 612-1000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
10204612
OR
106S00000X
Behavior Technician
—
—
Other
Enumeration date
04/09/2019
Last updated
08/14/2023
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