| NPI | 1730317033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE B FELLOWS Business Owner 503-472-2233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L4459) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 08-12-12) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2009-06-24 |