Individual
LAURA SHEFFIELD BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
8401 NE HALSEY ST, SUITE 203, PORTLAND, OR 97220-5670
(503) 977-0400
(208) 248-0977
Mailing address
8401 NE HALSEY ST, SUITE 203, PORTLAND, OR 97220-5670
(503) 977-0400
(208) 248-0977
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1678
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026862
OMAP NUMBER
OR
Enumeration date
05/05/2007
Last updated
09/30/2009
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