| NPI | 1942025598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA FOUNTAIN Clinical Social Worker/ Therapist 971-599-3881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2024-11-19 |
| Last Update Date | 2024-11-19 |