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Individual

DR. RITA ELLEN MAYNARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
311 B AVE, SUITE R, LAKE OSWEGO, OR 97034-3055
(503) 692-4092
Mailing address
311 B AVE, SUITE R, LAKE OSWEGO, OR 97034-3055
(503) 692-4092

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
847
OR

Other

Enumeration date
09/16/2016
Last updated
09/16/2016
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