| NPI | 1467598730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH K THOMAS Chief Executive Office 952-405-2583 |
| Organization Subpart ? | |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral |
| Additional Taxonomies | 225XP0200X Occupational Therapist Pediatrics |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2014-12-10 |