Individual
MELISSA GARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., B.C.B.A
Contact information
Practice address
0112 SW PENNOYER ST, PORTLAND, OR 97239-4368
(503) 235-3122
Mailing address
1346 SE 43RD AVE, APT. #4, PORTLAND, OR 97215-2400
(612) 432-4135
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/10/2012
Last updated
10/10/2012
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