| NPI | 1912387184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT LEE SCHAUSS Psychologist 651-388-0051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MN 10968) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MN 10968) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2015-06-03 |