Individual
KIMBERLY RENEE MCCOLLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2600 CENTER ST NE, SALEM, OR 97301-2669
(503) 947-2868
Mailing address
2600 CENTER ST NE, SALEM, OR 97301-2669
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2107
OR
Other
Enumeration date
09/25/2012
Last updated
09/25/2012
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