Individual
ELAINE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LP
Contact information
Practice address
3490 LEXINGTON AVE N, SHOREVIEW, MN 55126-8074
(651) 486-3808
(651) 486-3858
Mailing address
3490 LEXINGTON AVE N, SHOREVIEW, MN 55126-8074
(651) 486-3808
(651) 486-3858
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP3443
MN
Other
Enumeration date
01/02/2007
Last updated
07/08/2007
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