MEDICARE: MARIBEL VELASQUEZ OCAMPO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1720635253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIBEL VELASQUEZ OCAMPO

Provider Business Mailing Address
First Line	:	1212 CROWLEY AVE SE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-1912
Country	:	US
Telephone Number	:	503-689-0928
Fax Number	:

Provider Business Practice Location Address
First Line	:	2532 SANTIAM HWY SE # 114
Second Line	:
City	:	ALBANY
State	:	OR
Zip	:	97322-5211
Country	:	US
Telephone Number	:	541-236-2028
Fax Number	:	541-502-3362

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2019
Last Update Date	:	04/29/2024

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Directions to “ MARIBEL VELASQUEZ OCAMPO ” Practice Location

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