NPI | 1841000957 |
---|---|
Doing Business As | HOLLY WIGMORE |
Entity Type | Organization |
Authorized Contact | HOLLY WIGMORE Practice Owner 503-843-8862 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
Enumeration Date | 2025-01-10 |
Last Update Date | 2025-01-10 |