| NPI | 1467519686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE L KISH Licensed Psychologist 952-854-7771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP 3833) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2024-06-14 |