| NPI | 1154611812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICKA L BASSEY Owner/President 651-760-3923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 18505) |
| Enumeration Date | 2011-04-15 |
| Last Update Date | 2011-04-19 |