| NPI | 1124176326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS STEPHEN GREENSPON President 952-929-1499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2007-01-07 |
| Last Update Date | 2020-08-22 |