| NPI | 1215674742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE WILLIAMS Owner 651-243-2328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2022-05-17 |