NPI | 1023357175 |
---|---|
Entity Type | Organization |
Authorized Contact | HEATHER P LIBBEY Licensed Psychologist/Director 651-805-1752 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 5282) |
Enumeration Date | 2013-02-10 |
Last Update Date | 2013-08-07 |