| NPI | 1174813539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT WILLIAM MCLELLARN Director 971-645-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: OR 634) |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2015-04-03 |