| NPI | 1225379167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN G. LIETHEN Secretary 952-205-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 55779) |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2019-08-19 |