| NPI | 1508263039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL KACK Psychotherapist 507-530-3852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 16742) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 302218) |
| 101YP2500X Counselor, Professional | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2014-11-26 |