Mcmanimon Moe, Robert E

Mcmanimon Moe, Robert E is an individual health care provider with primary practice located at 131 Harriet St , Winona MN 55987-3177. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Mcmanimon Moe, Robert E can be contacted via phone (507) 454-2839.

Contact Information

Primary practice address
131 Harriet St Winona MN 55987-3177
Fax: (507) 454-5864
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X ADC-T Minnesota

Profile Details

NPI number 1447290374
LBN Legal business name Mcmanimon Moe, Robert E
Credentials BS, ADC-T
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Oct 5th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447290374 NPPES
Wisconsin MEDICAID 39344000

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