| NPI | 1710257175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE MADIMAN Licensed Psychologist 952-926-4554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP1361) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |