Jacqueline Ann Moeller, PSYD, LP
Individual provider Active NPI Clinical Psychologist · Golden Valley, MN
NPI 1861670960 · NPPES record last updated Jan 31, 2008
Key facts
- NPI
- 1861670960
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- LP4901 (MN)
- Practice address
- 3915 Golden Valley Rd
Courage Center
Golden Valley, MN 55422-4249 - Phone
- (763) 520-0344
- Fax
- (763) 520-0216
- NPI assigned
- Jan 31, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP4901 | MN | Yes |
Addresses
Primary practice location
3915 Golden Valley Rd
Courage Center
Golden Valley, MN 55422-4249
Mailing address
3915 Golden Valley Rd
Courage Center
Golden Valley, MN 55422-4249
Phone (763) 520-0344
Other names
- Jacqueline Ann Hinchliff
Other providers in Golden Valley, MN
- Minnesota Medical Imaging, LLC
- Minnesota Medical Services PLLC
- Sanjay K Mishra
- Mitchell Senior Services LLC
- Lori Ann Mitchell
- Nelly Mogeni
- Wafaa Hassan Mohamed
- Anab Said Mohamud
- Layla Muse Mohamud
- Moments Palliative Care LLC
All providers in Golden Valley, MN · Clinical Psychologist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.