| NPI | 1407189251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN HANSEN Licensed Psyychologist 651-434-3325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN Lp 3679) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP 3679) |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2009-09-11 |