Individual
AUTUMN MCCOLLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
912 NE KELLY AVE # 100C, GRESHAM, OR 97030-5629
(503) 912-5502
Mailing address
21600 OXNARD ST, WOODLAND HILLS, CA 91367-4976
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
OR
Other
Enumeration date
08/20/2021
Last updated
08/20/2021
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