Individual
DIANA POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
342 B AVE, LAKE OSWEGO, OR 97034-3012
(503) 303-7212
Mailing address
342 B AVE, LAKE OSWEGO, OR 97034-3012
(503) 303-7212
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-11-9466
OR
103K00000X
Behavior Analyst
BCBA 1-11-9466
CA
Other
Enumeration date
11/30/2012
Last updated
03/06/2019
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