| NPI | 1770194417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISE MARIE NOVAK Co Founder 651-240-2206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TH0004X Psychologist, Health |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 103TF0000X Psychologist, Family | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2020-08-16 |
| Last Update Date | 2020-09-18 |