Individual
CASSANDRA RAE BABCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9115 SW OLESON RD, PORTLAND, OR 97223-6875
(503) 569-8196
Mailing address
2151 COUNCIL CT NE, SALEM, OR 97305-1830
(503) 569-8196
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/31/2019
Last updated
04/09/2019
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