| NPI | 1982469664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE ANDERSON Owner 507-450-4886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-02-21 |
| Last Update Date | 2024-02-21 |