| NPI | 1992456644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARL D OLSON Owner 651-261-0972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2022-01-14 |