| NPI | 1063020691 |
|---|---|
| Doing Business As | COASTAL COUNSELING & CONSULTING LLC |
| Entity Type | Organization |
| Authorized Contact | PEGGY DEFAZIO Owner Provider 541-265-0884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-07-20 |