| NPI | 1700296936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER KEENA Therapist 320-333-1120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 18617) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2014-04-28 |