NPI | 1396275004 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIEL SCHMOYER Owner/Therapist 763-220-2312 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN LPCCCC01521) |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MN 01521) |
Enumeration Date | 2017-06-14 |
Last Update Date | 2023-02-07 |