Individual
MALLORY FIRESTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
219 42ND ST, SPRINGFIELD, OR 97478-5937
(541) 224-6987
Mailing address
2825 GREENTREE WAY, EUGENE, OR 97405-6230
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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