Individual
BOBBI-JO LISA MOUJID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
400 SIBLEY ST STE 500, SAINT PAUL, MN 55101-1938
(651) 256-1274
Mailing address
400 SIBLEY ST STE 500, SAINT PAUL, MN 55101-1938
(651) 256-1274
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
15873
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000
MHP
MN
01
—
113155
UCARE
MN
05
—
198428400
—
MN
01
—
217G9AZ
BLUE CROSS BLUE SHIELD
MN
01
—
990991042512
PREFERRED ONE
MN
Enumeration date
09/27/2005
Last updated
10/28/2014
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