| NPI | 1861286015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY MARIE MASTERS Child Therapist 612-578-2502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-04-04 |
| Last Update Date | 2025-04-04 |