| NPI | 1194938167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAVADA MAE GARRETT-AKINSANYA Clinical Psychologist 612-302-3140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP4105) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2015-09-24 |