| NPI | 1639104193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE MARIE GRESHAM Managing Partner 763-503-3981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2008-05-13 |