| NPI | 1932575891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY BOISJOLI Provider 651-315-5254 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 1009) |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2015-08-14 |