Individual
TYLA JOSEPHINE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2421 WASHBURN WAY STE 2631, KLAMATH FALLS, OR 97603-4525
(541) 885-1675
Mailing address
2418 VINE AVE, KLAMATH FALLS, OR 97601-3564
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
F6888433
CA
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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