Organization
ALLSIDES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA MOSE (OWNER)
(817) 891-8347
Entity
Organization
Contact information
Practice address
15248 72ND ST NE, OTSEGO, MN 55330-6536
(817) 891-8347
Mailing address
15248 72ND ST NE, OTSEGO, MN 55330-6536
(817) 891-8347
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/01/2021
Last updated
04/01/2021
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