| NPI | 1013322411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN PETHICK Clinical Psychologist 541-687-7787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR 1569) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2021-03-29 |