Individual
EMILY CUSHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2368 CRATER LAKE AVE STE 102, MEDFORD, OR 97504-5006
(541) 727-1592
Mailing address
PO BOX 3365, CENTRAL POINT, OR 97502-0014
(541) 727-1592
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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