| NPI | 1992006548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET CAROL STAM Sole Proprietor 763-754-2917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP4793) |
| Enumeration Date | 2010-11-13 |
| Last Update Date | 2010-11-13 |