| NPI | 1588896310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE MARIE PENTICOFF Owner, President 651-255-6678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP-4060) |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2009-08-12 |