| NPI | 1477940666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA J TRI Clinical Therapist 507-421-9676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 19398) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 19398) |
| 101YP2500X Counselor, Professional (Licence: MN 19398) | |
| Enumeration Date | 2015-04-25 |
| Last Update Date | 2015-04-25 |