Organization
MOSAIC PSYCHOLOGICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA RENEE BOCKHEIM PH.D. (OWNER)
(541) 248-9153
Entity
Organization
Contact information
Practice address
425 2ND AVE SW STE 204, ALBANY, OR 97321-2485
(541) 248-9153
Mailing address
425 2ND AVE SW STE 204, ALBANY, OR 97321-2485
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500809346
—
OR
Enumeration date
02/16/2018
Last updated
10/07/2022
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