| NPI | 1104307800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN ELIZABETH MCCLELLAND Ph.D. Psychologist, Clinical Direct 952-232-7712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-08-22 |