| NPI | 1710964218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVIDA GOLDMAN Owner 952-831-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2020-08-22 |