| NPI | 1891294138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN LUND Owner 612-245-4683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MN 12173) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 12173) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2018-06-16 |