| NPI | 1164247417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGO ABRAMS Manager 952-237-9095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2024-11-21 |
| Last Update Date | 2024-11-21 |