| NPI | 1922497965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH K OTTO Administrator 763-323-8050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 5822) |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2015-01-14 |