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Libby Broy

Behavior Technician in Portland, OR. Individual provider (NPI-1).

NPI number1841916632
StatusActive
Last updated in NPPESOct 13, 2022

Details

NPI
1841916632
Entity type
Individual (NPI-1)
Name
Libby Broy
Sex
Female
Sole proprietor
No
Enumeration date
Oct 13, 2022
Certification date
Oct 13, 2022
Last updated
Oct 13, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior TechnicianABA-IN-10226751ORYes

Practice location

1827 Ne 44th Ave Ste 390
Portland, OR 97213-1461

Phone 503-963-6494

Mailing address

8953 Ne Tennyson St Apt 309
Beaverton, OR 97006-2908

Phone 309-838-1376

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