| NPI | 1952005407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREL L HILLER Therapist 763-310-1352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2023-04-16 |