Moon, Virginia Ellen

Moon, Virginia Ellen is an sole proprietor health care provider with primary practice located at 203 South 16Th Court , Wautoma WI 54982. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Moon, Virginia Ellen can be contacted via phone (920) 787-6710.

Contact Information

Primary practice address
203 South 16Th Court Wautoma WI 54982
Phone: (920) 787-6710
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1780919506
LBN Legal business name Moon, Virginia Ellen
Credentials M.S.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 13th, 2009
Last updated Oct 13th, 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.

Request for update

Popular Providers