| NPI | 1033276258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROMELLE JOHNSON Licensed Psychologist 952-853-9919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP 3789) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-08-22 |