Individual
MISS HAVEN ELIZABETH PICKUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1791 PARK AVE NE, SALEM, OR 97301-8183
(541) 409-2798
Mailing address
121 SW SALMON ST # FI11, PORTLAND, OR 97204-2908
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
OR
Other
Enumeration date
06/06/2023
Last updated
06/06/2023
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