Individual
MS. LISA MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1833 3RD AVE, ANOKA, MN 55303-2424
(763) 421-5535
(763) 433-0226
Mailing address
7525 MITCHELL RD STE 100, EDEN PRAIRIE, MN 55344-1900
(952) 224-2282
(952) 224-2284
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
LP6538
MN
Other
Enumeration date
08/28/2017
Last updated
07/21/2020
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