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Individual

MRS. ANGELA KATHRYN PICKERING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
18765 SW BOONES FERRY RD, TUALATIN, OR 97062-8496
(503) 233-5405
Mailing address
1919 SE 36TH AVE, PORTLAND, OR 97214-5184
(530) 209-2944

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
10201681
OR
103K00000X
Behavior Analyst

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
164936
OR
Enumeration date
09/05/2016
Last updated
08/11/2021
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