| NPI | 1063887255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA BERTONE Executive Director 612-454-8692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MN 7587) |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2015-12-14 |