| NPI | 1700354040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER CLARK JOHNSON Therapist/Owner 541-604-0548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2018-11-05 |