| NPI | 1447440649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA MCCOURT Psychologist 651-294-2340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN LP 3883) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2008-11-07 |