| NPI | 1407867955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA BERGMAN President 218-740-3060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP1730) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2011-07-14 |