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1790496784
STEPHANIE MARIE HUMIWAT JESSUP
PORTLAND, OR
NPI
1790496784
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: OR ABA-IN-10227793)
Enumeration Date
2022-12-09
Last Update Date
2022-12-09
Business Address
STEPHANIE MARIE HUMIWAT JESSUP
415 SE 108TH AVE
PORTLAND, OR 97216-3127
Phone number: 916-753-9211
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Mailing Address
STEPHANIE MARIE HUMIWAT JESSUP
415 SE 108TH AVE
PORTLAND, OR 97216-3127
Phone number: 916-753-9211
Copy
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