| NPI | 1043275688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK J. CARROLL Licensed Psychologist 320-214-7733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP1747) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2020-08-22 |