Individual provider · Type 1 NPI

Mark Moore, MA

Mental Health Counselor · Waconia, MN

NPI number 1548679384 Active

Practice location

540 E 1st St
Waconia, MN 55387

Fax (952) 442-3084

Mailing address

9533 Roosevelt Dr
Chanhassen, MN 55317-4612

Other practice locations

  • 4570 W 77th St Ste 315, Edina, MN 55435-5035 · (952) 913-5403

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1548679384

Mark Moore, MA's National Provider Identifier is 1548679384, issued on Aug 6, 2014. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Waconia, MN. The record was last updated on Aug 9, 2018.