| NPI | 1336301894 |
|---|---|
| Doing Business As | ILLUMINATE |
| Entity Type | Organization |
| Authorized Contact | SHARON BLOSSOM President 651-264-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP-1196) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2008-06-26 |