Individual
LILI SUSAN KULM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1827 NE 44TH AVE STE 390, PORTLAND, OR 97213-1461
(503) 963-6494
Mailing address
9053 NE HALSEY ST, PORTLAND, OR 97220-5661
(208) 473-1000
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
ABA-IN-10224178
OR
Other
Enumeration date
07/12/2022
Last updated
07/12/2022
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