| NPI | 1801376587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY LEE MCMAHON Co Owner 651-342-2175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MN 81) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MN 3313) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MN 303560) | |
| 106H00000X Marriage & Family Therapist (Licence: MN 3313) | |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2018-08-21 |