| NPI | 1700968088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILL VANDERWALL Associate Vice President 1800-582-5260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 13632) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2020-08-22 |