| NPI | 1932219102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS GAMMELLO Administrator 218-828-1028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN 1437) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |