Individual
DR. JEAN E HALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
94174 10TH ST., GOLD BEACH, OR 97444
(541) 247-0678
(541) 247-0317
Mailing address
P.O. BOX 496, GOLD BEACH, OR 97444
(541) 247-0678
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1405
OR
103TB0200X
Cognitive & Behavioral Psychologist
1405
OR
103TC0700X
Clinical Psychologist
1405
OR
103TC1900X
Counseling Psychologist
1405
OR
103TP2701X
Group Psychotherapy Psychologist
1405
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262371
—
OR
Enumeration date
10/03/2006
Last updated
01/19/2010
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