Individual
NELLY MOGENI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1405 LILAC DR N STE 152, GOLDEN VALLEY, MN 55422-4536
(763) 516-1222
Mailing address
1405 LILAC DR N STE 152, GOLDEN VALLEY, MN 55422-4536
(763) 516-1222
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
10/06/2014
Last updated
10/06/2014
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