Organization
ADAGIO THERAPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTHA WANG PHD (CLINICAL PSYCHOLOGIST)
(818) 253-9264
Entity
Organization
Contact information
Practice address
388 STATE ST, SUITE 707, SALEM, OR 97301-3866
(818) 253-9264
Mailing address
388 STATE ST, SUITE 707, SALEM, OR 97301-3866
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2518
OR
1041C0700X
Clinical Social Worker
L6113
OR
Other
Enumeration date
05/05/2015
Last updated
05/05/2015
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