| NPI | 1053059105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIE WICK Marriage & Family Therapist 612-910-3108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2022-05-26 |