| NPI | 1124417878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMERA RAE MENSINK Owner 651-373-9440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 2179) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2018-03-20 |