Individual
TAMRA CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19800 VILLAGE OFFICE CT, 104, BEND, OR 97702-1872
(541) 241-0744
Mailing address
PO BOX 1432, BEND, OR 97709-1432
(541) 241-0744
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
ABA-IN-10173303
OR
Other
Enumeration date
01/08/2015
Last updated
09/28/2016
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