| NPI | 1427302363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC FRANCIS BOONE Owner 612-454-9798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 10413) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2022-06-13 |