| NPI | 1861588253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN E CHORBA Executive Director/CEO 952-894-4828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral |
| Additional Taxonomies | 103TF0000X Psychologist Family |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |