| NPI | 1194563213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISADIN HUSSEIN Owner 651-208-9451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2024-07-15 |