NPI | 1396084901 |
---|---|
Entity Type | Organization |
Authorized Contact | SHELLEY KAY HANSEN Owner 612-532-6741 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP3954) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN LSW5063) |
Enumeration Date | 2013-02-04 |
Last Update Date | 2014-04-02 |