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 |