| NPI | 1033484951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC EDWARD MOONEY Clinical Psychologist 612-991-6875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 4773) |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2012-03-09 |