| NPI | 1073578472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER HOLDREDGE Owner 763-482-9598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2023-06-12 |