| NPI | 1083163745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRYA DIETER Licensed Psychologist 763-478-1283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 5360) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-09-22 |