Individual
HEATHER MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
2424 32ND AVE S STE 103, GRAND FORKS, ND 58201-6509
(602) 248-8886
(602) 854-0504
Mailing address
8444 N 90TH ST STE 100, SCOTTSDALE, AZ 85258-4437
(602) 248-8886
(602) 854-0504
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1927
ND
171M00000X
Case Manager/Care Coordinator
—
—
174400000X
Specialist
—
—
Other
Enumeration date
04/05/2022
Last updated
04/07/2026
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