| NPI | 1396750188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN EIDEN VP Of Operations 651-379-1750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 06197) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 0145) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2016-03-02 |