Individual
SOOBIN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
701 SW 7TH ST, CORVALLIS, OR 97333-4359
(503) 822-8125
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/29/2026
Last updated
07/17/2026
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