| NPI | 1740293109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA C LEITHER Business Administrator 320-252-2976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 804348) |
| 101YM0800X Counselor, Mental Health | |
| 103TC1900X Psychologist, Counseling | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2021-03-02 |