| NPI | 1710245147 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | SHANNON MARIE SCHMIDT Psychologist 612-412-0236 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN LP2947) | 
| Enumeration Date | 2012-04-23 | 
| Last Update Date | 2012-04-23 |