| NPI | 1548822943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD EARL HOBBS Director Of Operations 651-338-6289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 207Q00000X Family Medicine | |
| 364SP0813X Clinical Nurse Specialist Psychiatric/Mental Health, Geropsychiatric | |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2021-12-14 |