| NPI | 1942687397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADE BENDEV RAFFERTY Psychologist/Owner 612-767-9860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP5587) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2015-10-29 |