Organization
MIGHTY OAK ABA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIRVANA KOWLESSAR-HIRSHLEIFER (OWNER)
(818) 427-6126
Entity
Organization
Contact information
Practice address
327 SE 139TH AVE, PORTLAND, OR 97233-1849
(818) 427-6126
Mailing address
327 SE 139TH AVE, PORTLAND, OR 97233-1849
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/09/2021
Last updated
03/09/2021
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