| NPI | 1114969409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN BREVARD MILLER President 763-595-7294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN 4359) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2008-05-20 |