| NPI | 1962800169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET M SCHULTZ Medical Biller 952-224-1905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MN H01471050090001) |
| Enumeration Date | 2014-12-21 |
| Last Update Date | 2014-12-21 |