| NPI | 1568092195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE JO SANDBULTE Co Owner 712-240-2785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-01-23 |
| Last Update Date | 2020-01-23 |