Individual
DORIS MOYLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13603 80TH CIR N, MAPLE GROVE, MN 55369-8961
(763) 274-3120
(763) 274-3121
Mailing address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
(651) 379-1718
(651) 379-1738
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
18625
MN
Other
Enumeration date
12/08/2015
Last updated
12/08/2015
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