| NPI | 1811286594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA LEE TAZELAAR Owner 651-699-6480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 9454) |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2015-03-25 |