| NPI | 1841382108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA WEBER Office Manager 218-839-4785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN 0103) |
| 103TC0700X Psychologist, Clinical (Licence: MN 2585) | |
| 103TC0700X Psychologist, Clinical (Licence: MN 4659) | |
| 103TC0700X Psychologist, Clinical (Licence: MN 1885) | |
| 103TC0700X Psychologist, Clinical (Licence: MN 4630) | |
| 103TC0700X Psychologist, Clinical (Licence: MN 1517) | |
| 1041C0700X Social Worker, Clinical (Licence: MN 00131) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2014-03-31 |