| NPI | 1235391590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER B DONAHUE Owner Psychologist 952-831-0422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 4589) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2008-06-27 |