| NPI | 1700895968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LEE KOGAN-WHITE President And CEO 651-645-0980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP 2974) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-08-22 |