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NPI Code Detail

MEDICARE: DR. RENE HELEN MOONEY PSYD

MEDICARE:  DR. RENE HELEN MOONEY  PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistLP4883MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477737120
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RENE HELEN MOONEY PSYD
Provider Business Mailing Address
First Line : 313 RIVERSIDE AVE
Second Line :
City : THIEF RIVER FALLS
State : MN
Zip : 56701-2825
Country : US
Telephone Number : 218-755-5050
Fax Number :
Provider Business Practice Location Address
First Line : 313 RIVERSIDE AVE
Second Line :
City : THIEF RIVER FALLS
State : MN
Zip : 56701-2825
Country : US
Telephone Number : 218-755-5050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2007
Last Update Date : 06/09/2020

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Directions to “ DR. RENE HELEN MOONEY PSYD” Practice Location

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