| NPI | 1386882496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GIBSON Licensed Clinical Social Worker 651-216-8899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 11191) |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2009-01-27 |