| NPI | 1124538293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCAS EBERHARDT DE MASTER Clinical Psychologist 971-220-5993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 2589) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2017-10-03 |