| NPI | 1538527262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC C LARSON Licensed Clinical Social Worker 952-405-6093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 19647) |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2016-02-09 |