| NPI | 1114045465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY BLOHM Owner 701-323-0924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2019-04-01 |