| NPI | 1144004490 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JENNIFER LYNN GRAHAM Licensed Professional Counselor 541-517-5177 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional | 
| Enumeration Date | 2023-08-18 | 
| Last Update Date | 2023-08-18 |