Individual
SAVONNA ORINDA CUDABACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3307 19TH AVE, FOREST GROVE, OR 97116-1909
(971) 348-3217
Mailing address
5850 GRANITE PKWY STE 600, PLANO, TX 75024-6753
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
ABA-IN-10219155
OR
Other
Enumeration date
02/16/2022
Last updated
02/16/2022
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