Individual
JERRY WAYNE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
THERAPUTIC MENTOR
Contact information
Practice address
60 MERRIMAC ST, HAVERHILL, MA 01830-6207
(978) 373-1126
Mailing address
60 MERRIMAC STREET, HAVEHILL, MA 01830
(978) 373-1126
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/09/2011
Last updated
09/09/2011
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