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General NPI Number Information
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NPI Number | 1295353621
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Entity Type | Individual
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Provider Name | MORIAH GABRIELLE KRUEGER LPCC
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Gender | Female
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Dates
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Enumeration Date | 07/13/2020
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 16016 233RD ST
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City | LITTLE FALLS
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State | MN
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Zip | 56345-5583
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Country | US
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Telephone | 320-632-5524
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Fax | 888-991-2741
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Provider Business Mailing Address
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Address Line | 16016 233RD ST
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City | LITTLE FALLS
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State | MN
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Zip | 56345-5583
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Country | US
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Telephone | 320-632-5524
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Fax | 888-991-2741
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CC03546
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CC03546
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License Number State | MN
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