NPI | 1548637507 |
---|---|
Entity Type | Organization |
Authorized Contact | VINCENT MILES Licensed Psychologist 1320-247-4737 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MN LP5676) |
Enumeration Date | 2015-08-26 |
Last Update Date | 2015-08-26 |