| NPI | 1730179995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDY MARIE EGGERT Director/Program Supervisor 507-424-3234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP0911) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2020-08-22 |