| NPI | 1891347357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE G GRENVIK Behavioral Health Professional 952-239-6354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-07-15 |