Individual
DR. RICHELLE N MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
UNIVERSITY OF MINNESOTA PHYSICIANS, 2312 SOUTH 6TH STREET, SUITE F256, 2B W, MINNEAPOLIS, MN 55454
(612) 273-8700
Mailing address
UNIVERSITY OF MINNESOTA PHYSICIANS, 2312 SOUTH 6TH STREET, SUITE F256, 2B W, MINNEAPOLIS, MN 55454
(612) 273-8700
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2440
MN
106H00000X
Marriage & Family Therapist
LP2440
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1012203
PREFERRED ONE
—
01
—
106588
UCARE
—
05
—
17886
—
ND
01
—
61-30122
MEDICA CHOICE
—
01
—
768274
ARAZ
—
01
—
8D932MO
BLUE CROSS BLUE SHIELD
—
05
—
922250200
—
MN
01
—
HP28967
HEALTH PARTNERS
—
Enumeration date
11/15/2006
Last updated
02/14/2012
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