| NPI | 1053757252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE BOSUSTOW BRULE Clinical Psychologist 541-953-3929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR 1832) |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2013-05-14 |