Individual
LINDA GAIL MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2465 HARRIS ST, EUGENE, OR 97405-3079
(541) 505-9911
Mailing address
2465 HARRIS ST, EUGENE, OR 97405-3079
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YM0800X
—
OR
Enumeration date
10/08/2009
Last updated
10/08/2009
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