Individual
SARAH E MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12537 60TH ST, PRINCETON, MN 55371-6626
(804) 263-8490
Mailing address
12537 60TH ST, PRINCETON, MN 55371-6626
(804) 263-8490
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11111
WAIVER PROGRAMS
—
Enumeration date
06/06/2020
Last updated
06/06/2020
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