| NPI | 1912279019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE MARIE NADEAU Psychotherapist 612-870-1242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 2807) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 0787) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-02-03 |