| Mikala L. Saccoman, Phd, Llc | |
|
497 Sw Century Dr Ste 104 Bend OR 97702-1167 | |
| (541) 678-5174 | |
| (541) 678-5017 |
| Full Name | Mikala L. Saccoman, Phd, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 497 Sw Century Dr Ste 104, Bend, Oregon |
| Authorized Official Name and Position | Mikala L Saccoman (OWNER) |
| Authorized Official Contact | 5416785174 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mikala L. Saccoman, Phd, Llc 497 Sw Century Dr Ste 104 Bend OR 97702-1167 Ph: (541) 678-5174 | Mikala L. Saccoman, Phd, Llc 497 Sw Century Dr Ste 104 Bend OR 97702-1167 Ph: (541) 678-5174 |
| NPI Number | 1164180683 |
|---|---|
| Provider Enumeration Date | 12/01/2021 |
| Last Update Date | 12/01/2021 |
| Certification Date | 12/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164180683 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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