| NPI | 1871650267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARITA RENEE SHAWCHUCK President 701-893-3419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2007-12-12 |