Individual
NICOLE HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2600 CENTER ST NE, SALEM, OR 97301-2669
(503) 519-8972
Mailing address
2600 CENTER ST NE, SALEM, OR 97301-2682
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3250
OR
Other
Enumeration date
08/04/2020
Last updated
03/04/2021
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