| NPI | 1811293384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANFORD E ESRY Mental Health Specialist Iii 541-324-2636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2011-02-01 |