| NPI | 1366908824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE CARREON Co Owner 507-317-9349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-02-20 |