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Organization
GROW WILD THERAPY CENTER, LLC
Active
Organization
GROW WILD THERAPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMANDA HUGHES-HUERTA LPC (CLINICAL DIRECTOR)
(757) 635-2869
Entity
Organization
Contact information
Practice address
6863 SE HENRY ST, PORTLAND, OR 97206-6508
(757) 635-2869
Mailing address
6863 SE HENRY ST, PORTLAND, OR 97206-6508
(757) 635-2869
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
05/02/2025
Last updated
05/02/2025
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