| NPI | 1992093421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE WILMOT Licensed Therapist 541-280-1570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR 77670496) |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2011-09-06 |