| NPI | 1124400908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY P COHN Co Director 541-210-8090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L6505) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2015-09-01 |