| NPI | 1104389170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIYANA LUCAS Licensed Clinical Social Worker 971-361-6747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2019-04-08 |