| NPI | 1093012478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT A FISCHER Licensed Psychologist 651-354-3371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MN LP4186) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MN LP4186) |
| Enumeration Date | 2011-02-19 |
| Last Update Date | 2013-04-18 |