| NPI | 1407978935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA R KOCH Licensed Psychologist 612-823-2063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP3420) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |