Organization
MOTIVATIONAL PARENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON WILCOX LCSW (DIRECTOR)
(541) 900-8244
Entity
Organization
Contact information
Practice address
50 CARMEL CT, ROSEBURG, OR 97471-4606
(541) 900-8244
Mailing address
1414 NW VALLEY VIEW DR # 107, ROSEBURG, OR 97471-1760
(541) 900-8244
(541) 524-4200
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
Other
Enumeration date
12/30/2021
Last updated
12/30/2021
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