| NPI | 1598194177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEISA IRWIN Director 763-786-4798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MN 190106) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2013-11-05 |