| NPI | 1437419397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEAL ALLEN GILLETT Owner 612-220-1151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP2348) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MN 8058) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2012-05-24 |