| NPI | 1871894931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN LUCILLE SHEEHAN BLOCHER Licensed Psychologist 651-235-6665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN LP1733) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 690) |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2010-11-05 |