| NPI | 1790419158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOLA WHITE Owner 503-917-9623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2022-07-12 |