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Behavioral Health & Social Service Providers Psychologist

Provider NPI: 1356590442

Provider Information:
Gender: F
Sole Proprietor

Practice Location:
559 FULVUE DR  EUGENE, OR 97405-2794 US
Tel: 541-852-2520  Fax: --

Business Mailing Address:
559 FULVUE DRIVE  EUGENE, OR 97405-2794 US
Tel: 541-852-2520  Fax: --

NPI Information:
NPI: 1356590442
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y103T00000XBehavioral Health & Social Service Providers
N103TA0400XBehavioral Health & Social Service Providers
N103TA0700XBehavioral Health & Social Service Providers
N103TB0200XBehavioral Health & Social Service Providers
N103TE1100XBehavioral Health & Social Service Providers
N103TF0000XBehavioral Health & Social Service Providers
N103TP2701XBehavioral Health & Social Service Providers
N103TH0004XBehavioral Health & Social Service Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 103T00000X





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