| NPI | 1780389189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TESSA FULTZ Owner/Therapist 763-760-2134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| 251B00000X Case Management | |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2024-01-22 |