| NPI | 1063534469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS GWYNNE WALES Psychotherapist 651-699-1062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 14061) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2008-06-16 |