Individual
TIANNA FAITH HALLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1650 SW 45TH PL, CORVALLIS, OR 97333-1768
(541) 757-8068
Mailing address
1650 SW 45TH PL, CORVALLIS, OR 97333-1768
(541) 757-8068
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
OR
171M00000X
Case Manager/Care Coordinator
Primary
—
OR
Other
Enumeration date
02/24/2022
Last updated
02/24/2022
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