| NPI | 1417328808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE J SLAVIK Office Manager 612-425-0092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN MN5396) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MN MN5609) |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2024-11-22 |