Individual
MS. VIRGINIA ELLEN MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
203 SOUTH 16TH COURT, WAUTOMA, WI 54982
(920) 787-6710
Mailing address
203 SOUTH 16TH COURT, WAUTOMA, WI 54982
(920) 787-6710
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/13/2009
Last updated
10/13/2009
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