| NPI | 1073625554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLEEN A. MAGORIAN Accounting Technician 541-476-2373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |