| NPI | 1164064341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENNA LYNN THOMPSON Licensed Clinical Social Worker/Own 701-818-7727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2019-10-09 |