| NPI | 1609095629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA SULLIVAN EHLERT Psychologist 612-284-1557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN LP5415) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2013-06-19 |