| NPI | 1487355020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA MAGNUSON Owner 763-200-1215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2023-03-10 |
| Last Update Date | 2024-08-29 |