| NPI | 1851054266 |
|---|---|
| Other Name | BDTXPDX |
| Entity Type | Organization |
| Authorized Contact | MICHAEL J FULOP Owner 503-539-4932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Additional Taxonomies | 103TH0004X Psychologist Health |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2022-12-07 |