| NPI | 1104094457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY THERESE SOUKUP Psychologist/Owner 320-253-2385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP3278) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2017-09-08 |