| NPI | 1104573252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP R LAZENBY Counselor/Owner 541-801-3730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 103T00000X Psychologist | |
| Enumeration Date | 2022-03-08 |
| Last Update Date | 2026-07-02 |