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1306203344
MIRA MAHENDRA CAVANAUGH
BEAVERTON, OR
NPI
1306203344
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OR C3985)
Enumeration Date
2016-01-21
Last Update Date
2019-01-18
Business Address
MIRA MAHENDRA CAVANAUGH MA, LPC, ATR
12578 SW BROADWAY ST
BEAVERTON, OR 97005-2136
Phone number: 503-367-3268
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Mailing Address
MIRA MAHENDRA CAVANAUGH MA, LPC, ATR
13001 SW 63RD PL
PORTLAND, OR 97219-8068
Phone number:
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