| NPI | 1972057644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY GOLDETSKY CEO 763-545-6017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2016-08-10 |