| NPI | 1912111204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA J WELLER Owner 218-525-2059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy (Licence: MN 00300) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 00300) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |