| NPI | 1144634452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA NICOLE ERICKSON Executive Director 612-910-9962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 20515) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2014-06-13 |