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Individual

RICHARD ALLEN MOLDENHAUER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LADC, LPCC,LCADC

Contact information

Practice address
W8972 520TH AVE, ELLSWORTH, WI 54011-4887
(715) 220-2078
Mailing address
W8972 520TH AVE, ELLSWORTH, WI 54011-4887
(715) 220-2078

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
300047
MN
101YM0800X
Mental Health Counselor
CC00060
MN

Other

Enumeration date
11/26/2018
Last updated
11/26/2018
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