| NPI | 1134104912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOEL LARSON President 651-642-9317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2020-08-22 |