| NPI | 1043093636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY L. WANDREI Owner 651-755-7875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2023-08-16 |
| Last Update Date | 2023-08-16 |