| NPI | 1013566181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL JOHN DIMICK Psychologist 507-645-6575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |