| NPI | 1952842783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA SHALLCROSS Psychologist 612-524-8119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN LP5803) |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2017-03-13 |