| NPI | 1265462212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE K. FELTON President 763-531-0566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2024-10-16 |