| NPI | 1568733061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE KLEMZ WOLFSON Owner 612-382-8651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MN 1473) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 1473) |
| Enumeration Date | 2012-01-16 |
| Last Update Date | 2017-05-30 |