NPI | 1912530643 |
---|---|
Former Legal Business Name | POSITIVE DEVELOPMENT FOR YOUTH AND FAMILIES |
Entity Type | Organization |
Authorized Contact | JUSTIN WILLIAM BUSH Co Owner/Licensed Psychlogist 503-333-5213 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
Enumeration Date | 2020-02-21 |
Last Update Date | 2020-02-21 |