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Individual

KALON A HENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
9115 SW OLESON RD, PORTLAND, OR 97223-6875
(510) 328-7178
Mailing address
3720 SE 28TH PL APT 19, PORTLAND, OR 97202-3048
(214) 603-9872

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
03/31/2019
Last updated
04/01/2019
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