| NPI | 1417154220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MELINDA MOSER Administrative Supervisor 651-783-7502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MN 1036841-1-CRF) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2020-08-22 |