| NPI | 1578324455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER MARIE PETERSEN Mental Health Professional 218-407-4247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-01-18 |
| Last Update Date | 2024-01-29 |