| NPI | 1316253214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L. MILLER Licensed Psychologist 320-217-6025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN LP 4367) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2022-07-21 |