| NPI | 1619153624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELLE MARIAN JACOBS Licensed Social Worker 651-642-9883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 1785) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 699) |
| Enumeration Date | 2008-01-21 |
| Last Update Date | 2013-02-12 |