| NPI | 1467439067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA MCDANIELS Owner 651-501-4957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist Clinical | |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2020-08-22 |