Individual
ALLISON MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA-R
Contact information
Practice address
14839 SE 82ND DR, CLACKAMAS, OR 97015-7624
(503) 372-5147
Mailing address
113 N ELM ST, CANBY, OR 97013-3519
(503) 372-5147
(503) 266-8632
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10202144
OREGON RBAI
OR
01
—
23-QMHA-R-4219
QMHA-R
OR
01
—
RBT-19-95343
BACB
—
Enumeration date
04/30/2020
Last updated
10/16/2023
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