| NPI | 1487732764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC VERNER LARSSON Clinical Director 612-925-8365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 10211043) |
| 103TC0700X Psychologist, Clinical (Licence: MN LP1531) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2021-08-31 |