| NPI | 1902942667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANETTE FAYE CONCEPCION Owner 651-714-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP2958) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |