Individual
ALISHA WEATHERLY-KERSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9115 SW OLESON RD, PORTLAND, OR 97223-6875
(770) 241-5540
Mailing address
9115 SW OLESON RD, PORTLAND, OR 97223-6875
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024401200
—
FL
Enumeration date
03/13/2018
Last updated
08/09/2019
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