Individual
KIMBERLY HAZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1409 NE DIAMOND LAKE BLVD, ROSEBURG, OR 97470-3347
(541) 440-4777
Mailing address
2336 RICHARDSON RD, MYRTLE CREEK, OR 97457-9752
(541) 604-9475
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
142037
OR
Other
Enumeration date
04/06/2026
Last updated
04/06/2026
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