Organization
SOUTHERN OREGON ABA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NIKOLE APRIL MCEWEN MS, BCBA, LBA (CLINICAL DIRECTOR/OWNER)
(541) 727-1592
Entity
Organization
Contact information
Practice address
2030 TAYLOR RD, CENTRAL POINT, OR 97502-1762
(541) 727-1592
(541) 664-3407
Mailing address
2030 TAYLOR RD, CENTRAL POINT, OR 97502-1762
(541) 727-1592
(541) 664-3407
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
ABA-B-10175208
OR
Other
Enumeration date
10/09/2017
Last updated
10/09/2017
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