| NPI | 1568766244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIKEN ELLEN WOGSTAD-HANSEN Ph D, Lp, RN, Cns 651-603-0540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2011-01-10 |