| NPI | 1902015308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM WALTER DUFFY Executive Director 651-261-1571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP0134) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-11-07 |