| NPI | 1720382062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIKEN WOGSTAD-HANSEN Ph D, Lp, RN, Cns 651-603-0540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult |
| Enumeration Date | 2010-12-30 |
| Last Update Date | 2010-12-30 |