| NPI | 1831542562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE KOSKI Administrator 651-674-9928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 363L00000X Nurse Practitioner | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 106H00000X Marriage & Family Therapist | |
| 111N00000X Chiropractor | |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2017-01-12 |