NPI | 1043609449 |
---|---|
Entity Type | Organization |
Authorized Contact | MARVIN SEPPALA Chief Medical Officer 651-213-4825 |
Organization Subpart ? | No |
Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
Enumeration Date | 2015-01-22 |
Last Update Date | 2015-04-29 |