| NPI | 1194549691 |
|---|---|
| Other Name | PORTLAND NEURODIVERGENT CLINIC |
| Entity Type | Organization |
| Authorized Contact | CASSANDRA FALLON MIASNIKOV Owner/Clinical Director 971-202-0047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-11-12 |
| Last Update Date | 2024-11-12 |