Individual
LAUREL FUSON-LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
905 SE 14TH AVE, PORTLAND, OR 97214-2569
(503) 622-8964
Mailing address
905 SE 14TH AVE, PORTLAND, OR 97214-2569
(503) 622-8964
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3512
OR
Other
Enumeration date
06/23/2015
Last updated
11/27/2023
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