| NPI | 1639553167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYCIA CANAVAN Speech Language Pathologist 541-371-2782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OR 15420) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2015-07-14 |