| Ch Moore Phd Dba Pediatric & Family Psychology Center Pa | |
|
2440 N Charles Street Suite 236 North Saint Paul MN 55109-3050 | |
| (651) 771-4766 | |
| (651) 771-4784 |
| Full Name | Ch Moore Phd Dba Pediatric & Family Psychology Center Pa |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2440 N Charles Street, North Saint Paul, Minnesota |
| Authorized Official Name and Position | C L Moore (OWNER) |
| Authorized Official Contact | 6517714766 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ch Moore Phd Dba Pediatric & Family Psychology Center Pa 2440 N Charles Street Suite 236 North Saint Paul MN 55109-3050 Ph: (651) 771-4766 | Ch Moore Phd Dba Pediatric & Family Psychology Center Pa 2440 N Charles Street Suite 236 North Saint Paul MN 55109-3050 Ph: (651) 771-4766 |
| NPI Number | 1104826510 |
|---|---|
| Provider Enumeration Date | 07/28/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104826510 | NPI | - | NPPES |
| 6049644 | Other | MN | STATE OF MN |
| HP19293 | Other | MN | HEALTH PART NERS |
| 39036800 | Medicaid | WI | |
| 104097 | Other | MN | UCARE |
| 212T8PE | Other | MN | BC/BS/BT |
Affrocare Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2488 Belmont Ln E, North Saint Paul, MN 55109 Phone: 651-592-6614 | |
Bhsi, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2497 7th Ave E, Suite 101, North Saint Paul, MN 55109 Phone: 651-769-6437 Fax: 651-769-6426 |