| NPI | 1679664254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J. WOLFRAM President 320-420-1146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP3758) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MN LP3758) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2012-09-07 |