| NPI | 1710943089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS DOE Owner 952-457-5163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 103T00000X Psychologist |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2021-08-11 |