| NPI | 1881144178 |
|---|---|
| Former Legal Business Name | TERESA I. COSTA, PSYD |
| Entity Type | Organization |
| Authorized Contact | TERESA IONE COSTA Clinical Psychologist 541-412-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 2356) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OR L6298) |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2016-10-11 |