| NPI | 1477261170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON WILCOX Partner 541-900-8244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-11-10 |
| Last Update Date | 2024-08-28 |