| NPI | 1154502631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER R COOPER Clinical Psychologist 541-207-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OR 1835) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OR 1835) |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2007-11-26 |