| NPI | 1275819914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA SAMLASKA Owner/Operator 651-317-3656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 5411) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2011-10-26 |