| NPI | 1114175791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY RUTH MOORE Psychologist/Owner 612-871-4336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP1891) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2008-09-08 |