| NPI | 1992090260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRIS KOESTNER Licensed Clinical Social Worker 612-798-7373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 08765) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2011-06-15 |