Most Relevant Information
Provider Data
| NPI Number: | 1003271677 |
| Provider Name: | STACEY MEADS |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/23/2015 |
| Last Updated: | 03/19/2019 |
Provider Practice Location
018 SW BOUNDARY CT
PORTLAND
OR
972393939
Practice Location Phone/Fax
| Phone: | 5032229661 |
| Fax: |
Provider Mailing Location
018 SW BOUNDARY CT
PORTLAND
OR
972393939
Provider Mailing Phone/Fax
| Phone: | 5032229661 |
| Fax: |