LICCI JAIMES PsyD
Individual Provider (NPI-1)
Active
Psychologist, Clinical
Provider Information
- NPI Number
1417473992- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PsyD
- Status
- Active
Contact & Location
- Address
- 115 NE MAY LN, MCMINNVILLE, OR, 971289272
- Phone
- (503) 472-1338
- Fax
- (503) 434-8597
Specialties & Taxonomies
Psychologist, Clinical
Primary License: OR #3095