| Richelle Moen, Phd Llc | |
|
4826 Chicago Ave Ste 207 Minneapolis MN 55417-1063 | |
| (612) 743-7788 | |
| (612) 824-7341 |
| Full Name | Richelle Moen, Phd Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4826 Chicago Ave Ste 207, Minneapolis, Minnesota |
| Authorized Official Name and Position | Richelle Naomi Moen (OWNER) |
| Authorized Official Contact | 6127437788 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richelle Moen, Phd Llc 4826 Chicago Ave Ste 207 Minneapolis MN 55417-1063 Ph: () - | Richelle Moen, Phd Llc 4826 Chicago Ave Ste 207 Minneapolis MN 55417-1063 Ph: (612) 743-7788 |
| NPI Number | 1801169347 |
|---|---|
| Provider Enumeration Date | 02/14/2012 |
| Last Update Date | 02/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801169347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LP2440 (Minnesota) | Primary |
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