Antanida Basargin

NPI #1144716382 in Woodburn, Oregon

Provider Information

NPI Number: 1144716382
Entity Type: Individual
Name: Antanida Basargin
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jul 10, 2018
Last Updated: Jul 10, 2018

Practice Location

Address: 1369 N PACIFIC HWY STE 1369
City: Woodburn
State: Oregon
ZIP Code: 97071-3617
Phone: (971) 338-7764

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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