Provider Demographics
NPI:1720635253
Name:VELASQUEZ OCAMPO, MARIBEL
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:VELASQUEZ OCAMPO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 CROWLEY AVE SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1912
Mailing Address - Country:US
Mailing Address - Phone:503-689-0928
Mailing Address - Fax:
Practice Address - Street 1:2532 SANTIAM HWY SE # 114
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-5211
Practice Address - Country:US
Practice Address - Phone:541-236-2028
Practice Address - Fax:541-502-3362
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician