| NPI | 1659852093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ALAN MANTELL Psychologist 651-503-6322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN LP4396) |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2018-08-23 |