| NPI | 1164070348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA LOUISE WHATSON Clinical Psychologist 651-341-4838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2019-08-30 |
| Last Update Date | 2019-08-30 |