| NPI | 1649631656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYNE LOKKEN Psychologist 320-255-0343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN LP4377) |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2016-03-18 |