| NPI | 1144673971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | S L DEFAZIO Consulting Psychologist 971-225-0114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 103TE1100X Psychologist, Exercise & Sports |
| 103TH0004X Psychologist, Health | |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-16 |
| Last Update Date | 2016-07-16 |