| NPI | 1285103382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKKI MCKOY Owner 612-889-5899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2018-11-19 |