Individual
MADELINE WENZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2914 NW ESSEX AVE, ALBANY, OR 97321-9231
(541) 250-0215
Mailing address
2914 NW ESSEX AVE, ALBANY, OR 97321-9231
(541) 250-0215
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
ABA-IN-10248535
OR
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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