| NPI | 1790081214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MICHELLE HENDRICKSON President/Psychologist 612-845-8768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP4455) |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2024-01-30 |