| NPI | 1437233285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA AMARIS Director Of Clinical Services 651-765-4306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP4391) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-08-22 |