Individual
DR. TODD FRANCIS MORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LICSW
Contact information
Practice address
308 4TH AVE NW, AUSTIN, MN 55912-3140
(507) 438-2010
(507) 434-0955
Mailing address
1009 36TH ST NW, AUSTIN, MN 55912-6661
(507) 438-2010
(507) 434-0955
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
15984
MN
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12345678
—
MN
05
—
452809300
—
MN
Enumeration date
03/14/2007
Last updated
08/26/2020
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