| NPI | 1982389284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM KIRKLAND Owner/Agent 651-434-9312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 102L00000X Psychoanalyst | |
| 103K00000X Behavior Analyst | |
| 103T00000X Psychologist | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 1041C0700X Social Worker Clinical | |
| 225XM0800X Occupational Therapist Mental Health | |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2023-06-15 |