| NPI | 1326449026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN C PLUCAR Psychologist 612-388-6095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN 5703) |
| 103TC0700X Psychologist, Clinical | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2015-02-18 |