| Moonflower | |
|
5445 City Hall St Nisswa MN 56468-2478 | |
| (218) 820-1023 | |
| Not Available |
| Full Name | Moonflower |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5445 City Hall St, Nisswa, Minnesota |
| Authorized Official Name and Position | Mallori Ann Sheik (DR. DSW LICSW OWNER/OPERATOR) |
| Authorized Official Contact | 2188201023 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moonflower 5445 City Hall St Nisswa MN 56468-2478 Ph: (218) 820-1023 | Moonflower 5445 City Hall St Nisswa MN 56468-2478 Ph: (218) 820-1023 |
| NPI Number | 1295557213 |
|---|---|
| Provider Enumeration Date | 10/30/2024 |
| Last Update Date | 10/30/2024 |
| Certification Date | 10/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295557213 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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