| NPI | 1962143974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY LEE WYMAN Psychotherapist/Owner 218-341-9632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-04-05 |