| NPI | 1114221926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KANDEE KUBAT TIMMERMAN Therapist 612-251-1753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 15043) |
| Enumeration Date | 2011-01-08 |
| Last Update Date | 2011-01-08 |