| NPI | 1558782250 |
|---|---|
| Other Name | CMMHC |
| Entity Type | Organization |
| Authorized Contact | LORI MELISSA SCHMIDT Executive D Irector 320-202-2033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MN 800356-1-MHC) |
| Enumeration Date | 2013-12-23 |
| Last Update Date | 2014-01-02 |