| NPI | 1962878751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN CAMPION Provider 612-483-3487 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN LP 4079) |
| Enumeration Date | 2015-08-15 |
| Last Update Date | 2015-08-15 |