| NPI | 1699286591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MARIE WENDELBORG Owner 541-525-9416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L5896) |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2017-10-18 |