| NPI | 1215718481 |
|---|---|
| Doing Business As | TARA WALDRON |
| Entity Type | Organization |
| Authorized Contact | TARA WALDRON Owner 651-242-3290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2023-10-12 |