| NPI | 1982848883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENDA CEDARLEAF Therapist 763-546-5797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 17268) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 17268) |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2009-10-26 |