| NPI | 1780177337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL WATSON Licensed Psychologist 612-758-0583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MN LP6081) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2018-11-08 |