Individual
MARILYN MEADE-MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2518 E 43RD ST, MINNEAPOLIS, MN 55406-3058
(612) 710-0996
Mailing address
2518 E 43RD ST, MINNEAPOLIS, MN 55406-3058
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0949
MN
Other
Enumeration date
03/20/2007
Last updated
04/16/2008
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