| NPI | 1033580758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER WHEELER Manager 541-668-7613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C4522) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 69925) |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2022-07-21 |