| NPI | 1003576653 |
|---|---|
| Doing Business As | CPGR |
| Entity Type | Organization |
| Authorized Contact | DENNIS HANNON Chief Executive Officer 952-222-8162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Enumeration Date | 2021-12-22 |
| Last Update Date | 2024-04-11 |