Individual
MELISSA VENTOLA-PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 W BOND ST, ASTORIA, OR 97103-6009
(503) 325-0241
Mailing address
90 NW BIRCH AVE, WARRENTON, OR 97146-9647
(508) 685-9327
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/29/2018
Last updated
12/01/2020
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