| NPI | 1033347331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAE G PETRANGELO Speech Language Pathologist 651-636-4155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: MN 7340) |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: MN 7109) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2016-01-28 |