| NPI | 1700972122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA M. GREEN Co Owner 701-746-6336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2017-01-23 |