Individual
CELINE LOUISE MOOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
2118 BLAISDELL AVE, MINNEAPOLIS, MN 55404-2415
(612) 270-2588
Mailing address
2118 BLAISDELL AVE, MINNEAPOLIS, MN 55404-2415
(612) 270-2588
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305770
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DWT124785383001
BCBS- MINNESOTA
MN
Enumeration date
09/30/2021
Last updated
09/30/2021
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