| NPI | 1083005664 |
|---|---|
| Doing Business As | FUNCTIONAL KIDS CLINIC |
| Entity Type | Organization |
| Authorized Contact | JULIE ERNEST President/Owner 651-770-8884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MN 6402) |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2015-03-02 |