| NPI | 1780992479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL VITO DESANCTIS Licensed Psychologist 651-225-9222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN 1395) |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2010-09-28 |