Individual
KY'ALLAH PHIDA BELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1675 SW MARLOW AVE STE 200, PORTLAND, OR 97225-5102
(510) 679-3545
Mailing address
119 SE 165TH AVE, PORTLAND, OR 97233-3822
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/12/2019
Last updated
04/12/2019
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