| NPI | 1407821937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY L. HICKS President 541-683-5024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OR 436) |
| Enumeration Date | 2006-02-19 |
| Last Update Date | 2020-08-22 |