Most Relevant Information
Provider Data
| NPI Number: | 1003246653 |
| Provider Name: | DELLA M RADKE QMHA |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/19/2013 |
| Last Updated: | 02/20/2015 |
Provider Practice Location
4890 32ND AVE SE
SALEM
OR
973179350
Practice Location Phone/Fax
| Phone: | 5035885647 |
| Fax: | 5035880509 |
Provider Mailing Location
4890 32ND AVE SE
SALEM
OR
973179350
Provider Mailing Phone/Fax
| Phone: | 5035885647 |
| Fax: | 5035880509 |