| NPI | 1831722594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA DINESH SHAH Owner/Chief Executive Officer 612-276-2462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2020-02-20 |