ACT II PSYCHOLOGY INC. NPI 1700164878

NPI Information

ACT II PSYCHOLOGY, INC. is a mental health (including community mental health center) clinic center in Salem, OR. ACT II PSYCHOLOGY, INC. NPI is 1700164878. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is N/a.

The provider's business location address is:

189 LIBERTY ST., SE, SUITE 210A
THE REED OPERA HOUSE
SALEM, OR
ZIP 97301
Phone: (503) 400-7500
Fax: (503) 581-1069

The provider's authorized official is David Cory Brillhart .
The authorized official title is Clinical Psychologist and has the following contact phone number (503) 400-7500.

The enumeration date for this NPI number is 7/23/2011 and was last updated on 7/27/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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