| Doctor Name: | MRS. MIMI ANN COGSWELL |
| NPI Number: | 1063494482 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, LPC |
| License Number: | C1561 |
| Business Practice Address: | 714b Main St Suite 201 Oregon City, OR - 970451821 |
| Business Phone Number: | 5037405742 |
| Business Fax Number: | 5037223964 |
| Mailing Address: | 17520 Holly Ln, OREGON CITY |
| State: | OR |
| Postal Code: | 970458523 |
| Phone Number: | 5037405742 |
| Fax Number: | 5037223964 |
| NPI Enumeration Date: | 11/20/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | C1561 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |