| NPI | 1912782749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY ALLEN Owner, Therapist 952-295-8815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2026-06-04 |