| NPI | 1194687772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA GRAY Marriage And Family Therapist 612-461-7460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-12-02 |
| Last Update Date | 2025-12-02 |