| NPI | 1588726939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL R VILLANUEVA Owner 541-608-3878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2018-07-16 |