Organization
KOSMOS PSYCHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAT PRINCE KOSMOS PSYD (OWNER)
(503) 714-1144
Entity
Organization
Contact information
Practice address
2355 STATE ST STE 101, SALEM, OR 97301-4541
(503) 714-1144
Mailing address
2355 STATE ST STE 101, SALEM, OR 97301-4541
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
Primary
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629567599
—
OR
Enumeration date
09/27/2024
Last updated
09/27/2024
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