| NPI | 1649613837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD ALLEN MCLELLAN Licensed Psychologist 763-572-2605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 0295) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2024-11-08 |