| NPI | 1902562374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL MEYER Owner 612-401-4573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2021-11-10 |
| Last Update Date | 2021-11-10 |