Individual
JONATHAN MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
141 MAIN ST, DANSVILLE, NY 14437-1314
(585) 335-5052
(585) 335-5061
Mailing address
141 MAIN ST, DANSVILLE, NY 14437-1314
(585) 335-5052
(585) 335-5061
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
093396-1
NY
Other
Enumeration date
12/11/2014
Last updated
12/18/2014
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