| NPI | 1104038215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA SUSAN COHEN President 612-379-5360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP1749) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |