| NPI | 1780468132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY LYNN TWEEDT Lpc/Ladc 507-407-2177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YS0200X Counselor, School | |
| Enumeration Date | 2023-08-24 |
| Last Update Date | 2023-08-24 |