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Individual

MISS LINNEA MARY MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BA

Contact information

Practice address
1720 BASSETT DR, MANKATO, MN 56001-6569
(507) 565-0150
Mailing address
1720 BASSETT DR, MANKATO, MN 56001-6569
(507) 565-0150

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
247200000X
Other Technician
Primary

Other

Enumeration date
04/09/2019
Last updated
12/14/2020
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