| NPI | 1598168700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE ANDERSON Licensed Psychologist 612-910-1890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN LP5350) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2014-10-01 |