| NPI | 1679968341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA JANE HAAKANA Owner 952-928-0618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN LP1056) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2015-03-31 |