| NPI | 1043545189 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | RUTH M. MYERS Psychiatrist 952-898-7578  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 49576)  | 
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-03-1206)  | 
| Enumeration Date | 2009-10-07 | 
| Last Update Date | 2009-10-07 |