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Individual

GRESSA WIDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3729 KLINDT DR, THE DALLES, OR 97058-3566
(541) 298-2101
(541) 298-7796
Mailing address
3729 KLINDT DR, THE DALLES, OR 97058-3566
(541) 298-2101
(541) 298-7796

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103K00000X
Behavior Analyst
Primary
ABA-B-10250168
OR
106S00000X
Behavior Technician

Other

Enumeration date
12/04/2015
Last updated
12/09/2024
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