| NPI | 1649378019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNIE ELIZABETH EMANUEL Licensed Psychologist 651-274-1203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN LP4645) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2024-03-18 |