| NPI | 1164180683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKALA L SACCOMAN Owner 541-678-5174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| Enumeration Date | 2021-12-01 |
| Last Update Date | 2021-12-01 |