Individual
JESSICA RAE MOENCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC, OWNER/DIRECTOR
Contact information
Practice address
1000 8TH ST SE STE A, DETROIT LAKES, MN 56501-2819
(218) 847-0696
(218) 847-4198
Mailing address
1000 8TH ST SE STE A, DETROIT LAKES, MN 56501-2819
(218) 847-0696
(218) 847-4198
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302886
MN
Other
Enumeration date
08/23/2010
Last updated
11/20/2024
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