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1164010625
ALLIE MARIE RANDALL
GRESHAM, OR
NPI
1164010625
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: OR ABAIN10211664)
Enumeration Date
2021-01-09
Last Update Date
2021-01-09
Business Address
ALLIE MARIE RANDALL
912 NE KELLY AVE # 100C
GRESHAM, OR 97030-5629
Phone number: 503-912-5502
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Mailing Address
ALLIE MARIE RANDALL
3500 NE 17TH ST APT A107
GRESHAM, OR 97030-4567
Phone number: 503-933-1855
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