| NPI | 1912382615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER A MANNING Owner 218-416-2268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 16294) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2015-07-22 |