| NPI | 1265974844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | XULIVONG MOUA Psychotherapist 651-340-5216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MN cc00494) |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2024-12-13 |