| NPI | 1194184465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUISE PHELPS PAGE Psychotherapist/Partner 612-251-4753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MN CC00282) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MN 4714) |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2016-02-16 |