| NPI | 1912285776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL JEAN WOODBURY Psychotherapist 952-767-0539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 0274) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2011-07-28 |