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General NPI Number Information
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NPI Number | 1083947295
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Entity Type | Individual
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Provider Name | MICHELLE DENISE MOSER LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/08/2009
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Last Update Date | 09/08/2009
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Provider Practice Location Address
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Address Line | 309 BUSH ST SUITE #1
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City | RED WING
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State | MN
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Zip | 55066-2505
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Country | US
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Telephone | 651-301-1369
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Fax | 651-388-4850
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Provider Business Mailing Address
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Address Line | 1828 PERLICH AVE APT 3D
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City | RED WING
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State | MN
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Zip | 55066-2977
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Country | US
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Telephone | 651-301-1369
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Fax | 651-388-4850
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1828
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License Number State | MN
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