| NPI | 1851892079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARDOWSA MOHAMED ALI Owner 952-454-0421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MN 2187) |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-02-22 |