| NPI | 1316274681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN PORTZEN Administrative Director 651-266-5206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 16439) |
| Enumeration Date | 2009-11-07 |
| Last Update Date | 2009-11-07 |