Individual
UNIQUE ANGELICA MENDOZA-MONDRAGON
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
737 WISTERIA ST, INDEPENDENCE, OR 97351-9553
(503) 881-3007
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
ABA-IN-10219664
OR
Other
Enumeration date
01/13/2022
Last updated
01/13/2022
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