| NPI | 1578824330 |
|---|---|
| Former Legal Business Name | CAROL STEPHENS |
| Entity Type | Organization |
| Authorized Contact | CAROL M STEPHENS Owner 612-251-7413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP3384) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2012-09-28 |