| NPI | 1639531353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMERA GRAZIANO Provider 763-333-4718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN R217553-5) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-07-13 |