| NPI | 1871619577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH LYNNE ANDERSON Licenced Psychologist 612-374-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |