| NPI | 1215647607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAIBEH BENSON Nurse Practitioner (Pmhnp) 651-398-4820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2022-11-28 |