Autumn Mccollum

NPI #1578239331 in Gresham, Oregon

Provider Information

NPI Number: 1578239331
Entity Type: Individual
Name: Autumn Mccollum
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Aug 20, 2021
Last Updated: Aug 20, 2021

Practice Location

Address: 912 NE KELLY AVE # 100C
City: Gresham
State: Oregon
ZIP Code: 97030-5629
Phone: (503) 912-5502

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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