| NPI | 1972648046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA CRANDALL Psychologist 612-803-7368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN lp4201) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-08-22 |