| NPI | 1922552066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEXI MILLER Licensed Practitioner 952-895-5038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 347C00000X Private Vehicle (Licence: MN X554209453714) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: MN M4020) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2016-08-05 |