| NPI | 1053730622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY EVE GUSS Licensed Clinical Social Worker 541-779-2390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2014-04-10 |