| NPI | 1780394171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA CLARK Psychiatric Nurse Practitioner 651-724-2905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2022-11-28 |