| NPI | 1043651052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA KITTILSON Owner/Therapist 651-276-8446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 13033) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 301518) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2013-07-08 |