| NPI | 1356676472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOLORES JANE MATTHEWS Licensed Psychologist 612-379-8050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 2240) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN 3936) |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2009-10-07 |