| NPI | 1366501314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER BRADY Bookkeeper 651-221-0913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 810472-1-MHC) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2020-08-22 |