| NPI | 1386412310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA MARIE MINER Mental Health Therapist 651-300-2609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2023-12-19 |