Individual provider · Type 1 NPI
Jessica Rae Moench, LADC, OWNER/DIRECTOR
Addiction (Substance Use Disorder) Counselor · Detroit Lakes, MN
NPI number
1104132505
Active
Practice location
1000 8th St SE Ste A
Detroit Lakes, MN 56501-2819
Fax (218) 847-4198
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 302886 (MN) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1104132505
Jessica Rae Moench, LADC, OWNER/DIRECTOR's National Provider Identifier is 1104132505, issued on Aug 23, 2010. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Detroit Lakes, MN. The record was last updated on Nov 20, 2024.