Individual
COURTNEY RAQUEL CALAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
912 NE KELLY AVE STE 100C, GRESHAM, OR 97030-5629
(503) 912-5502
Mailing address
1851 SE HALE PL, GRESHAM, OR 97080-9255
(702) 994-8680
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/02/2019
Last updated
11/02/2019
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