| NPI | 1215278601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANISA MOHAMMED Clinical Director 612-259-7746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 6097) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP5667) |
| 103TC0700X Psychologist, Clinical (Licence: MN LP5667) | |
| 1041C0700X Social Worker, Clinical (Licence: MN 165) | |
| 106H00000X Marriage & Family Therapist (Licence: MN 162) | |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2017-02-07 |