| NPI | 1447524285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY JOSEPH FREITAS Licensed Psychologist 952-442-0040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP 4675) |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2012-05-12 |