Individual
JENNI FUSCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5847 NE 122ND AVE STE 101, PORTLAND, OR 97230-1079
(971) 339-7040
Mailing address
10 MARBEE RD, ROCKPORT, MA 01966-1743
(978) 879-9168
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/12/2019
Last updated
02/25/2021
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