| NPI | 1982313045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL LAWRENCE MATSON Owner, CEO 507-740-0467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-11-17 |
| Last Update Date | 2022-11-17 |