| NPI | 1336615202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA PATTEN Director 612-389-2332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YP2500X Counselor, Professional | |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2018-10-18 |
| Last Update Date | 2019-09-20 |