| NPI | 1487144986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLGA LEONOVA Program Director 971-217-7754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health | |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2018-05-10 |