| NPI | 1760549893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH M. NASH Manager 952-844-0619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP0181) |
| Enumeration Date | 2007-01-01 |
| Last Update Date | 2020-08-22 |