| NPI | 1992025639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK DOYLE Clinical Director 651-454-0114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 13805) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2010-06-04 |