| NPI | 1083944367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA LYNN KAISER Clinical Social Worker 612-825-8053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 01158) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 216) |
| Enumeration Date | 2010-01-08 |
| Last Update Date | 2010-01-08 |