| NPI | 1184650400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL GOOSSENS President 218-722-4058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP2592) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP4732) |
| 1041C0700X Social Worker, Clinical (Licence: MN 7560) | |
| 1041C0700X Social Worker, Clinical (Licence: MN 6443) | |
| 1041C0700X Social Worker, Clinical (Licence: MN 19635) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2021-04-09 |