| NPI | 1518067750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY DARLENE MILLICENT Licsw 320-828-1092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 16030) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2011-11-20 |