| NPI | 1023093473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI DAWN DIMOND Executive Director 952-608-8403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 08879) |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2020-08-22 |