| NPI | 1053711663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL SUERA Clinical Psychologist 507-424-6954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN LP 5772) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2023-04-19 |