| NPI | 1457011371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATI KLITZKE Licensed Clinical Psychologist 320-640-2980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-12-20 |
| Last Update Date | 2022-01-25 |