| NPI | 1720593841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA ANDERSON Licensed Psychologist 612-963-7027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP5161) |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2017-12-12 |