| NPI | 1619363223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID RAYNOLDS Clinical Director 541-821-6623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C0943) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2015-04-09 |