| NPI | 1558510404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON MICHAEL O'MALLEY Administrator 763-682-9011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MN 7720) |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2008-09-16 |