| NPI | 1467439067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA MCDANIELS Owner 651-501-4957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103T00000X Psychologist | |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2025-09-11 |