| NPI | 1386202091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | D'UNDRA RYNISE WILLIS Mental Health Professional 612-412-4819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2024-11-22 |