Individual
LYNELLE BENIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SCHOOL PSYCHOLOGIST
Contact information
Practice address
8835 SW CANYON LN, PORTLAND, OR 97225-3443
(503) 380-3747
Mailing address
3890 SW 96TH AVE, PORTLAND, OR 97225-2519
(503) 380-3747
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
30305
OR
103TS0200X
School Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58472
CENTURY SURETY COMPANY
OH
Enumeration date
10/21/2019
Last updated
10/21/2019
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