| NPI | 1982237269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES SCHUTT Co Owner 612-219-7120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 103TC0700X Psychologist Clinical | |
| Enumeration Date | 2020-02-14 |
| Last Update Date | 2020-02-14 |