| NPI | 1205095833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA BLOOM Director Of Counseling 952-884-4882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist | |
| 103TF0200X Psychologist, Forensic | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TP0814X Psychologist, Psychoanalysis | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 103TR0400X Psychologist, Rehabilitation | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2024-06-03 |