| NPI | 1013577030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM SKON Owner/Therapist 218-556-6438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2020-01-03 |