| NPI | 1710767074 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MATTHEW CHRISTIAN SPITZMUELLER Clinical Social Worker 612-979-4150 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical | 
| Enumeration Date | 2023-10-04 | 
| Last Update Date | 2024-08-13 |