| NPI | 1093107500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA MYRNA RODRIGUEZ QUICK Clinical Social Worker 952-237-3876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2015-02-21 |
| Last Update Date | 2016-01-23 |