| NPI | 1023690765 |
|---|---|
| Doing Business As | WILD AWAKEN THERAPY |
| Entity Type | Organization |
| Authorized Contact | ELIZABETH L HUMMER Owner 503-705-5241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2021-04-22 |