| NPI | 1972159770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER KAY WADESON Licensed Clinical Psychologist 701-541-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2019-08-16 |