| NPI | 1639743453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAH MARIE OSBORN Psychologist Owner 952-220-3268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103G00000X Clinical Neuropsychologist | |
| 103TF0200X Psychologist Forensic | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2021-05-17 |