| NPI | 1760710685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS E DANIEL Therapist 763-682-2011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MN LICSW 11618) |
| Enumeration Date | 2009-12-04 |
| Last Update Date | 2009-12-04 |