| NPI | 1710963988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAIDA GRACE GUNTHER Owner 763-425-1185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist Clinical | |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2020-08-22 |