| NPI | 1114574936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY COHN Owner 541-313-6199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2024-02-21 |