| NPI | 1598800146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JACOBS Bussiness Director 612-872-9446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |