| 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 |