| NPI | 1952712572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KELLER Owner 763-442-4111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP4821) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2014-05-16 |