| NPI | 1285121194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLECIA GRACE DECOUTEAU Owner 503-654-4959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OR 15632) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2022-02-23 |