| NPI | 1295121648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY GAYLE COULTER Supervisor 320-316-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 1503) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2015-04-13 |