Individual
DR. MARISOL ELISA BEAULAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2920 SE BROOKWOOD AVE STE A, HILLSBORO, OR 97123-8553
(971) 417-6054
Mailing address
2920 SE BROOKWOOD AVE STE A, HILLSBORO, OR 97123-8553
(503) 352-7333
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
3828
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700256989
—
OR
Enumeration date
05/06/2019
Last updated
10/01/2024
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