| NPI | 1588794515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOS PETSOULIS Director 218-727-7353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP3014) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP3664) |
| 1041C0700X Social Worker, Clinical (Licence: MN 15629) | |
| 103G00000X Clinical Neuropsychologist (Licence: MN LP4322) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-12-18 |