| NPI | 1558603373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY WAYNE WILD President 541-550-7940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C1740) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2013-03-19 |