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Individual
DR. KERIANNE MAUCH MOON
Active
Individual
DR. KERIANNE MAUCH MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
16592
MN
1041C0700X
Clinical Social Worker
Primary
60361
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113415900
—
MN
Enumeration date
12/08/2006
Last updated
12/13/2016
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