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1841167103
MOONWELL THERAPY LLC
PORTLAND, OR
NPI
1841167103
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Entity Type
Organization
Authorized Contact
SHABD K KHALSA
Owner/Lpc
512-689-7173
Organization Subpart ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2025-10-21
Last Update Date
2025-10-21
Business Address
MOONWELL THERAPY LLC
4721 SW 45TH AVE
PORTLAND, OR 97221-3620
Phone number: 512-900-7602
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Mailing Address
MOONWELL THERAPY LLC
4721 SW 45TH AVE
PORTLAND, OR 97221-3620
Phone number: 512-900-7602
Copy
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