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Individual

CINDY RAE MOE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LP

Contact information

Practice address
8590 EDINBURGH CENTER DR, BROOKLYN PARK, MN 55443-3723
(763) 425-5959
(763) 425-5929
Mailing address
1214 LOWRY AVE N, MINNEAPOLIS, MN 55411-1370
(612) 910-1035

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0094
MN
103T00000X
Psychologist
LPOO94
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
A818440000
MN
Enumeration date
03/02/2021
Last updated
03/02/2021
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