| NPI | 1871228734 |
|---|---|
| Other Name | N/A |
| Entity Type | Organization |
| Authorized Contact | JOSHUA GOODWIN Owner/Psychotherapist 651-245-9901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-07-23 |
| Last Update Date | 2024-03-25 |