| NPI | 1942331889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MEDLICOTT ECKFELDT Psychologist 651-644-2267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP3045) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |