| NPI | 1942850763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL SCHUTT Chief Operating Officer 651-308-9401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2020-10-01 |