Organization
YASMINE MOIDEEN, PHD, LP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YASMINE MOIDEEN PHD, LP (PRESIDENT)
(651) 484-0000
Entity
Organization
Contact information
Practice address
2332 LEXINGTON AVE N, ROSEVILLE, MN 55113-4336
(651) 484-0000
(651) 639-1314
Mailing address
2332 LEXINGTON AVE N, ROSEVILLE, MN 55113-4336
(651) 484-0000
(651) 639-1314
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP3742
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190G8MO
BCBS
MN
01
—
61-50789
UBH
MN
01
—
LP3742
LICENSE - PSYCHOLOGIST
MN
Enumeration date
03/05/2007
Last updated
08/22/2020
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