| NPI | 1750742300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER J JOHNSON Licensed Psychologist 612-294-9458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN 5388) |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2023-09-06 |