| NPI | 1194232264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANISA SOPHIA MOHAMMED Psychologist 612-568-1475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP5667) |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2018-01-10 |