| NPI | 1649163874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER LAURA SCHUPP Owner 651-689-3012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2025-05-28 |
| Last Update Date | 2025-11-04 |