Individual
ROBERT KENNETH MOESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LLP
Contact information
Practice address
6360 JACKSON RD., STE. M, ANN ARBOR, MI 48103
(734) 930-0031
Mailing address
10291 RIDGELINE DR., MILAN, MI 48160
(734) 439-1732
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301009756
MI
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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