| NPI | 1003009457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA RHAE AVDEM Business Manager 701-662-1911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ND 269) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2007-08-20 |