| NPI | 1548664295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN M MCGINNIS Owner 612-916-0207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2014-10-09 |