| NPI | 1497820039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MELLBERG Director 763-550-9005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 801884-1-MHC) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN 801884-1-MHC) |
| 103TC0700X Psychologist, Clinical (Licence: MN 801884-1-MHC) | |
| 103TC1900X Psychologist, Counseling (Licence: MN 801884-1-MHC) | |
| 1041C0700X Social Worker, Clinical (Licence: MN 801884-1-MHC) | |
| 106H00000X Marriage & Family Therapist (Licence: MN 801884-1-MHC) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-08-22 |