Individual
JAHMI LEE FISCUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
401 E 3RD ST, THE DALLES, OR 97058-2562
(541) 298-2101
(541) 298-2101
Mailing address
1103 F AVE, LA GRANDE, OR 97850-2027
(541) 910-5264
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
ABA-IN-10187570
OR
Other
Enumeration date
11/28/2017
Last updated
11/28/2017
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