| NPI | 1164488847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD JENSEN Executive Director 218-822-3736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP 4642) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2020-08-22 |