Individual
MELINDA SUZANNE MOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, APSW
Contact information
Practice address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-8164
(920) 674-7611
Mailing address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-8164
(920) 674-7611
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
127579-121
WI
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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