| NPI | 1053002881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA NIKOVICS Owner 612-203-0849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2024-01-09 |