| NPI | 1073331252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAT PRINCE KOSMOS Owner 503-714-1144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC0700X Psychologist, Clinical | |
| 103TC1900X Psychologist, Counseling | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| Enumeration Date | 2024-09-27 |
| Last Update Date | 2024-09-27 |