| NPI | 1134138316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNDRA HEARN ANTONSON President 952-938-3947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 11804) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-08-22 |