IndividualActive
Allie Randall
NPI 1164010625 · Behavior Technician · Gresham, OR
Provider details
- NPI number
- 1164010625
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- ABAIN10211664 (OR)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
912 Ne Kelly Ave # 100c
Gresham, OR 97030-5629
Phone: (503) 912-5502
Approximate (ZIP-level) locationGet directions
Mailing address
3500 Ne 17th St Apt A107
Gresham, OR 97030-4567
Registry dates
- Enumerated
- 2021-01-09
- Last updated
- 2021-01-09
- Certified
- 2021-01-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.