| NPI | 1982719118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERI L BRUNETTI Owner 763-428-4060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MN LP4169) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP4169) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2009-06-29 |