Individual
MAURICE LEE SHOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
115 WEST FIRST ST, FAIRMONT, MN 56031
(507) 238-4757
(507) 238-1574
Mailing address
115 WEST FIRST ST, FAIRMONT, MN 56031
(507) 238-4757
(507) 238-1574
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
08673
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310458 UBS
UNITED BEHAVIORAL HEALTH
MN
01
—
7G524SH
BLUE CROSS BLUE SHIELD
MN
Enumeration date
10/03/2006
Last updated
07/08/2007
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