| NPI | 1225233406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLGA GRUN Clinical Psychologist 651-523-8808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP 4405) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2020-08-22 |