| NPI | 1548906803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI L LARIVIERE Founder, Psychiatry Director 612-723-6417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2022-05-10 |
| Last Update Date | 2022-05-10 |