Individual
ALYSSA JOY LIBAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9115 SW OLESON RD, PORTLAND, OR 97223-6875
(877) 910-6538
Mailing address
601 PALO ALTO DR, VANCOUVER, WA 98661-6626
(360) 624-0870
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/20/2020
Last updated
07/20/2020
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