| NPI | 1902170343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA BACUYANI Manager 541-316-8004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OR 12904) |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2019-06-24 |