| NPI | 1134502990 |
|---|---|
| Former Legal Business Name | AUTOPOIETICA: THE CREATIVE WELLNESS STUDIO |
| Entity Type | Organization |
| Authorized Contact | HALLORY MOGREN Therapist/Partner 971-645-4499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR A3606) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C3680) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2015-06-29 |