| NPI | 1639747918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARISSA STEPAN Co Owner 651-236-0976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2021-06-14 |