| NPI | 1952159410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE KATHRYN LAURENT Owner 952-465-1608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2024-05-09 |
| Last Update Date | 2025-04-28 |