| NPI | 1992465793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY JEAN GIMBEL Owner 763-691-3793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2021-12-21 |
| Last Update Date | 2021-12-21 |