| NPI | 1750412680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE KNUTE LOKKESMOE Licensed Psychologist 952-435-0022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP3587) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP1249) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2008-07-03 |