Individual
TERRELL FUNCHES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BEHAVIOR TECHNICIAN
Contact information
Practice address
3535 N LOMBARD ST, PORTLAND, OR 97217-5901
(800) 273-4292
(714) 596-6274
Mailing address
11037 WARNER AVE # 339, FOUNTAIN VALLEY, CA 92708-4007
(800) 273-4292
(714) 596-6274
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/19/2021
Last updated
01/19/2021
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