Healthcare Provider Details

I. General information

NPI: 1306757018
Provider Name (Legal Business Name): ANGIE L MOHS LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 MAIN ST N STE 201B
HUTCHINSON MN
55350-1819
US

IV. Provider business mailing address

1110 BLUEJAY DR SW
HUTCHINSON MN
55350-3828
US

V. Phone/Fax

Practice location:
  • Phone: 320-292-3926
  • Fax:
Mailing address:
  • Phone: 320-292-3926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34676
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: