| NPI | 1861580607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY BUSHMAN President 952-898-5020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN LP3946) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2018-04-05 |