| NPI | 1295167880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD ALAN DICKSON Nurse Practitioner 218-256-7570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MN CNP-1591) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2023-09-06 |