| Mason Moore Consultants | |
|
5009 Excelsior Blvd Ste 136 St Louis Park MN 55416-3049 | |
| (952) 925-5343 | |
| Not Available |
| Full Name | Mason Moore Consultants |
|---|---|
| Speciality | Psychologist |
| Location | 5009 Excelsior Blvd Ste 136, St Louis Park, Minnesota |
| Authorized Official Name and Position | James Allison Moore (OWNER) |
| Authorized Official Contact | 9529255343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mason Moore Consultants 5009 Excelsior Blvd Ste 136 St Louis Park MN 55416-3049 Ph: (952) 925-5343 | Mason Moore Consultants 5009 Excelsior Blvd Ste 136 St Louis Park MN 55416-3049 Ph: (952) 925-5343 |
| NPI Number | 1033275748 |
|---|---|
| Provider Enumeration Date | 12/28/2006 |
| Last Update Date | 09/26/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033275748 | NPI | - | NPPES |
| 11934MO | Other | MN | BCBS GROUP NUMBER |
| 6109358 | Other | MN | MEDICA ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP2399 (Minnesota) | Primary |
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