| NPI | 1720453111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN BROOKS Owner 541-350-6913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201050080NP) |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2015-12-10 |