| NPI | 1376318873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LOUISE LEE Neuropsychologist 320-761-3644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2023-11-15 |
| Last Update Date | 2023-11-15 |