| NPI | 1699038265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOLLIE O'BRIEN Executive Director 651-917-2370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP5419) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2024-10-07 |