Individual
MRS. NIRVANA GABRIELA KOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DR, ED.D., BCBA, LBA
Contact information
Practice address
8445 SW 57TH AVE, PORTLAND, OR 97219-3270
(786) 362-4128
Mailing address
8445 SW 57TH AVE, PORTLAND, OR 97219-3270
(786) 362-4128
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
812138900
—
FL
Enumeration date
09/06/2007
Last updated
04/03/2024
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