Individual
MR. DANIEL JOHN MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
220 N 6TH AVE E, DULUTH, MN 55805-1952
(218) 249-7000
Mailing address
220 N 6TH AVE E, DULUTH, MN 55805-1952
(218) 249-7000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3320
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
714572100
—
MN
Enumeration date
05/15/2006
Last updated
09/14/2017
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