Individual
MIMOSA CONSTANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
11575 SW PACIFIC HWY # 2323, TIGARD, OR 97223-8671
(971) 450-2875
Mailing address
11575 SW PACIFIC HWY # 2323, TIGARD, OR 97223-8671
(971) 450-2875
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C10974
OR
106H00000X
Marriage & Family Therapist
R12310
OR
Other
Enumeration date
09/09/2022
Last updated
05/16/2026
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